经会阴及经直肠前列腺穿刺活检术的临床应用及护理

Ultrasound-guided transrectal prostate biopsy and transperineal prostate biopsy: a comparative study

目的比较超声引导下经直肠及经会阴两种前列腺穿刺活检术的结果,总结护理体会。方法回顾性分析166例前列腺穿刺活检病例,其中经直肠径路102例,经会阴径路64例,记录穿刺后肉眼血尿、下尿路症状、排尿困难、急性尿潴留、发热、血便、会阴部肿胀及患者舒适度。结果经直肠径路组穿刺阳性率为46.1%,经会阴途径组穿刺阳性率为42.2%,两组差异无统计学意义(P>0.05);穿刺后血尿、下尿路症状、排尿困难和急性尿潴留发生率,两组间差异无统计学意义(P>0.05)。经直肠径路组发热、血便的发生率显著高于经会阴径路组(P<0.05),而会阴肿胀的发生率在经会阴径路组显著性增高(P<0.05)。经直肠途径患者较经会阴途径患者更舒适(t=9.69,P<0.05)。结论超声引导下经直肠和经会阴前列腺穿刺活检术都是诊断前列腺癌的有效方法,并发症发生率各有特点,但经直肠前列腺穿刺活检舒适度更高。

Objective To understand the efficacy of ultrasound-guided transrectal prostate biopsy and that of transperineal prostate biopsy and to review our nursing work. Method A retrospective analysis was first conducted into 166 cases of prostate biopsy,which included 102 cases of ultrasound-guided transrectal biopsy and 64 cases of transperineal biopsy. The symptoms of gross hematuria,lower urinary tract symptoms,dysuria,acute urinary retention,fever,bloody stools,perineum swelling,and comfort level were observed and documented. Findings The positive rate of the transrectal group and that of the transperineal group was 46. 1% and 42. 2% respectively. No significant difference was observed between the two biopsy methods（ P〉0. 05）. No significant difference was either observed in the common complications such as hematuria,lower urinary tract symptoms,dysuria and acute urinary retention between the two groups. However,the infection and rectal bleeding rates of transrectal biopsy were higher than transperineal biopsy,while perineum swelling was more common in the transperineal group. Comfort of transrectal biopsy group was better than that of the transperineal biopsy group（ t = 9. 69,P〈0. 05）. Conclusion Ultrasound-guided transrectal and transperineal biopsies are both effective for the diagnosis of prostate cancer. Complications resulting from the two methods may vary,but the transrectal biopsy method is much more convenient and has a higher comfort level.