超声引导下两种前列腺穿刺活检方法的效果比较

Effect comparison of two prostate biopsy methods guided by ultrasound

目的比较超声引导下经直肠前列腺穿刺活检与经会阴前列腺穿刺活检两种方法的效果。方法将77例前列腺穿刺患者随机分为两组，经直肠前列腺穿刺活检组38例，经会阴前列腺穿刺组39例，记录术后肉眼血尿，肉眼血尿持续时间、血便、尿路刺激征、感染、会阴部肿胀、尿液潜血阳性时间及患者舒适度。结果两组患者肉眼血尿、尿路刺激征发生率比较差异无统计学意义（P〉0．05）；经直肠前列腺穿刺活检患者血便、感染发生例数分别为13，10例，明显高于经会阴前列腺穿刺（2，4例），差异有统计学意义（x2=9．620，8．013；P〈0．05）；经会阴前列腺穿刺患者会阴部肿胀、肉眼血尿持续时间、潜血阳性时间分别为6例，（26．1±3．6）h，（9．3±3．7）d，明显高于经直肠前列腺穿刺0例，（18．3±4．2）h，（6．6±2．2）d，差异均有统计学意义（x2=11．236，t=8．075，4．587；P〈0．05）。经直肠途径患者较经会阴途径患者舒适（t=9．740，P〈0．05）。结论经会阴前列腺穿刺活检较经直肠途径更为安全，经直肠前列腺穿刺活检操作简便、舒适度高。

Objective To compare the effect between ultrasound guided transrectal prostate biopsy and transperineal prostate biopsy which guided by ultrasound. Methods Totals of 77 patients needed prostate biopsy were randomly divided into two groups, 38 cases in transrectal prostate biopsy group and 39 cases in transperineal prostate biopsy group. After operation, gross hematuria, duration of gross hematuria, bloody stool, urinary tract infection, infection, perineum swelling, duration of urine occult blood and comfort level were observed. Results There was no significantly difference about gross hematuria and urinary tract infection ratio in two groups （P 〉0. 05）. The bloody stool and infection of transrectal biopsy group were 13 cases and 10 cases respectively, higher than that in transperineal biopsy group that were 2cases and 4cases, and the difference was statistically significant（ x2 = 9. 620,8. 013 ; P 〈 0. 05 ）. The perineum swelling, duration of gross hematuria and urine occult blood in transperineal biopsy group were 6cases, （26.1 ± 3.6）hours, （9.3 ± 3.7）days, higher than 0 case, （ 18.3 ± 4.2） hours, （6.6 ± 2.2） days that in transrectal biopsy group, and the difference was statistically significant （ x2 = 11. 236, t = 8.075,4. 587 ;P 〈 0. 05 ）. Comfort of transrectal biopsy group was better than that of transperineal biopsy group （ t = 9. 740, P 〈 0. 05 ）. Conclusions Transperineal biopsy method is safer than transrectal biopsy method, while the transrectal biopsy method is much more convenient and has a higher comfort level.