两种肠道管理下前列腺穿刺并发症和血清高敏C反应蛋白变化的比较

A comparative study on complications and serum high sensitive C-reactive protein changes between two methods of enema in preparation for prostate biopsy

目的 比较两种肠道管理行超声引导下前列腺穿刺术并发症发生率和术后血清高敏C反应蛋白水平变化。方法 将2013年1月至2014年12月广东省佛山市第一人民泌尿外科可疑前列腺癌并行前列腺穿刺活检患者383例随机分为A、B两组,A组（n=192）穿刺前晚及穿刺晨用0.1%∽0.2%肥皂水500∽800 ml清洁灌肠;B组（n=191）术前晚无须清洁灌肠,仅使用磷酸钠盐灌肠液保留灌肠,术前1 h进行0.1%∽0.2%肥皂水500∽800 ml清洁灌肠,排清水便即可。两组术前及术后1 d,3 d,5 d测定血清高敏C反应蛋白水平;比较两组术后并发症率。结果 A组发生并发症患者70例（35.2%）,发热（T〉38℃）伴寒战8例（4%）;B组发生并发症患者62例（32.5%）,发热（T〉38℃）8例,出现寒战6例（3.1%）,两组术后并发症发生率差别无统计学意义（P均〉0.05）;两组术后1 d,3 d,5 d血清高敏C反应蛋白水平变化趋势一致,各时间节点血清高敏C反应蛋白值差别无显著统计学意义（P均〉0.05）。结论 穿刺术前晚磷酸钠盐灌肠液保留灌肠可取代0.1%∽0.2%肥皂水500∽800 ml清洁灌肠。

Objectives To compare the clinical complications and serum high sensitive C-reactive protein （hsCRP） changes between two methods of enema in preparation for prostate biopsy. Patients who were suspicious of prostate cancer and underwent transrectal ultrasound-guided prostate biopsy in the First People＇s Hospital of Foshan from January 2013 to December 2014 were selected and randomly divided into two groups （Group A and Group B）. In Group A, 192 patients had cleansing enema using 0.1% -0.2% suds both at the night before biopsy and at the morning of biopsy, while in Group B 191 patients only had cleansing enema at the morning of biopsy and had sodium phosphates enema at the night before biopsy. Results 70 patients （35.2%） in Group A had complications,8 of whom got fever （T〉38℃） and shivering. Similarly, 62 patients （32.5%） developed complications in group B, 8 of whom got fever and 6 of whom had shivering. There were no significant differences in complications and serum hsCRP at any time points between these two groups. Conclusion Enema using sodium phosphates may be reasonable altemative to using cleansing enema at the night before biopsy.