直肠超声引导下经会阴与经直肠前列腺穿刺活检效果比较

Comparison of the effect of transperineal and transrectal prostate puncture biopsy guided by transrectal ultrasonography

目的比较直肠超声引导下经会阴与经直肠前列腺穿刺活检的临床效果。方法选取2014年1月至2016年5月于漯河市第二人民医院行前列腺穿刺活检患者117例,其中经会阴穿刺58例(经会阴穿刺组),经直肠穿刺59例(经直肠穿刺组),对2组患者的前列腺穿刺活检结果及穿刺相关并发症进行比较。结果经会阴穿刺组58例患者前列腺穿刺病理检查结果为前列腺癌18例(31.03%)、慢性前列腺炎16例(27.59%)、良性前列腺增生24例(41.38%),经直肠穿刺组59例患者前列腺穿刺病理检查结果为前列腺癌20例(33.90%)、慢性前列腺炎17例(28.81%)、良性前列腺增生22例(37.29%),2组患者前列腺穿刺病理检查结果比较差异无统计学意义(P>0.05)。经会阴穿刺组患者发热、血尿、血便、尿路感染、尿路刺激征、会阴肿胀和尿潴留发生率分别为3.45%(2/58)、8.62%(6/58)、1.72%(1/58)、3.45%(2/58)、3.45%(2/58)、6.90%(4/58)和3.45%(2/58),经直肠穿刺组患者发热、血尿、血便、尿路感染、尿路刺激征、会阴肿胀和尿潴留发生率分别为10.17%(6/59)、10.17%(6/59)、16.95%(10/59)、15.25%(9/59)、3.39%(2/59)、0.00%(0/59)和1.69%(1/59);经会阴穿刺组患者发热、血便及尿路感染发生率显著低于经直肠穿刺组(P<0.05),但会阴肿胀发生率显著高于直肠穿刺组(P<0.05);2组患者血尿、尿路刺激征及尿潴留发生率比较差异均无统计学意义(P>0.05);经会阴穿刺组和经直肠穿刺组患者总并发症发生率分别为31.03%(18/58)和57.63%(34/59),经会阴穿刺组患者总并发症发生率显著低于经直肠穿刺组(P<0.05)。结论经会阴前列腺穿刺与经直肠前列腺穿刺活检结果相当,但经会阴前列腺穿刺相关并发症发生率低。

Objective To compared the effect of transperineal and transrectal prostate puncture biopsy guided by transrectal ultrasonography. Methods A total of 117 patients who underwent prostate puncture biopsy were selected in the Second People＇s Hospital of Luohe City from January 2014 to May 2016. Among the patients,58 patients in transperineal prostate puncture biopsy group were performed with transperineal prostate puncture biopsy,and 59 patients in transrectal prostate puncture biopsy group were performed with transrectal prostate puncture biopsy. The results of prostate puncture biopsy and puncture-related complications were compared between the two groups. Results The pathological results of the 58 cases in transperineal prostate puncture biopsy group were prostate cancer in 18 cases（ 31. 03%）,chronic prostatitis in 16 cases（ 27. 59%） and benign prostatic hyperplasia in 24 cases（ 41. 38%）. The pathological results of the 58 cases in transrectal prostate puncture biopsy group were prostate cancer in 20 cases（ 33. 90%）,chronic prostatitis in 17 cases（ 28. 81%） and benign prostatic hyperplasia in 22 cases（ 37. 29%）. There was no significant difference in the results of prostate biopsy between the two groups（ P 〈 0. 05）. The incidence of fever,hematuria,bloody stool,urinary tract infection,urinary tract infection,urinary irritation symptoms,perineal swelling and urinary retention in transperineal prostate puncture biopsy group was 3. 45%（ 2 /58）,8. 62%（ 6 /58）,1. 72%（ 1 /58）,3. 45%（ 2 /58）,3. 45%（ 2 /58）,6. 90%（ 4 /58） and 3. 45%（ 2 /58）,respectively; the incidence of fever,hematuria,bloody stool,urinary tract infection,urinary tract infection,urinary irritation symptoms,perineal swelling and urinary retention in transrectal prostate puncture biopsy group was 10. 17%（ 6 /59）,10. 17%（ 6 /59）,16. 95%（ 10 /59）,15. 25%（ 9 /59）,3. 39%（ 2 /59）,0. 00%（ 0 /59） and 1. 69%（ 1 /59）,respectively. The incidences of fever,bloody stool and urinary tract infection in transperineal prostate puncture biopsy group were significantly lower than those in transrectal prostate puncture biopsy group（ P 〈 0. 05）,but the incidence of perineal swelling in transperineal prostate puncture biopsy group was significantly higher than that in transrectal prostate puncture biopsy group（ P 〈 0. 05）. There was no significant difference in the incidences of hematuria,urinary irritation symptoms and urine retention between the two groups（ P 〉 0. 05）.The total incidence of complications in transperineal prostate puncture biopsy group and transrectal prostate puncture biopsy group was 31. 03%（ 18 /58） and 57. 63%（ 34 /59） respectively,the total incidence of complications in transperineal prostate puncture biopsy group was significantly lower than that in transrectal prostate puncture biopsy group（ P 〈 0. 05）. Conclusion The results of transperineal prostate puncture biopsy and transrectal prostate puncture biopsy are similar,but the incidence of complications associated with the transperineal prostate puncture biopsy is significantly lower.