经直肠超声引导前列腺穿刺活检31例临床分析

The Clinical Value of Transrectal Ultrasound Guided Prostatic Biopsy

目的初步探讨直肠指检（DRE）、经直肠超声检查（TRUS）、前列腺特异性抗原（PSA）指标对前列腺穿刺活检病例的意义，并评价经直肠超声引导前列腺穿刺活检的安全性。方法对2006年8月-2007年7月临床疑似前列腺癌的患者31例行经直肠超声引导前列腺穿刺活检，根据诊断资料分析DRE、TRUS、PSA指标的灵敏度、特异度，并随访穿刺活检术后并发症情况。结果1．31例患者术后前列腺增生15例，前列腺癌13例，前列腺炎2例，前列腺结核1例；DRE、TRUS、PSA三者中，PSA的灵敏度最高，为92．3％，TRUS的特异度最高，为44．4％，本组穿刺活检对前列腺癌的检出率为41．9％，敏感度、特异度为100％；2．31例患者术中无明显疼痛，术后血尿8例，为25．8％：血便2例，为6．50％；发热2例，为6．50％，尿痛11例，为35．50％。结论经直肠超声引导前列腺穿刺活检是一种安全可靠的前列腺活检方法，操作简单，患者痛苦小，容易接受，该项穿刺技术是一种有效诊断前列腺癌的方法。

Objective To evaluate the meaning of digital rectal examination（DRE）, transreactal ultrasound scan（TRUS）, prostate specific antigen（PSA） in prosthetic biopsies patients and the safety of transreactal ultrasound guided prostatic biopsy. Methods 31patients suspected prostate cancer were performed prostatic biopsy guided by transreactal ultrasound between August 2006 to July 2007. The sensitivity and specificity of DRE, TRUS, PSA were analyzed according to pathology datas and the complications were followed up and analyzed. Results 1. Among those 31 cases ,15cases were benign prosthetic hyperplasia,13 cases were prostate cancer, 2 cases were prostatitis, 1 case was tabculosis of prostate. The sensitivity and specificity of PSA, DRE , TRUS is 92.3 %, 38.9%, 69.2 %, 33. 3 %, 76. 9 %, 44.4% o TRUS guided biopsy＇s sensitivity and specificity for diagnosis of prostate cancer were 100%,it＇s detection rate was 41.9%. 2. There wasn＇t evident pain in 31 patients, hematuria in 8 cases, account for 25.8 % ： bloody stools in 2 case, account for6.5 % ;fever in 2 cases, account for 6.5% ; odynuria in llcases, account for 35.5%. Conclusion Transrectal ultrasound guided prostatic biopsy is a safety prostate biopsy procedure and an efficient method of diagnosis prostate cancer.