经会阴前列腺穿刺与经直肠前列腺穿刺活检在前列腺癌诊断的初探

Transperineal prostate biopsy and transrectal prostate biopsy in the diagnosis of prostate cancer

目的对比经会阴与经直肠前列腺穿刺活检在前列腺癌诊断中的阳性率及并发症。方法回顾分析2017年1月到2019年12月行前列腺穿刺活检的病例,经直肠组187例,经会阴组68例。结果经直肠组阳性穿刺率为34.7%,经会阴组阳性穿刺率为29.4%,两组无统计学差异(P>0.05)。穿刺后经直肠组和经会阴组的血尿发生率分别为40.1%、42.6%,尿潴留发生率分别为6.9%、7.3%,直肠出血发生率分别为1.1%、0%,差别无统计学意义(P>0.05)。穿刺后经直肠组和经会阴组的会阴肿胀的发生率分别为2.6%、13.2%,两组有统计学差异(P<0.05)。结论超声引导下经直肠、经会阴前列腺穿刺活检均为前列腺癌诊断的有效方法。两者穿刺阳性率无明显差异,但并发症各有特点。

Objective To compare the positive rate and complications of transperineal and transrec⁃tal prostate biopsy in the diagnosis of prostate cancer.Methods from January 2017 to December 2019,187 patients underwent transrectal prostate biopsy and 68 underwent transperineal prostate biopsy.Results the positive puncture rate was 34.7%in the transrectal group and 29.4%in the transperineal group,there was no statistical difference between the two groups(P>0.05).After biopsy,the incidence of hematuria was 40.1%in the transrectal group and 42.6%in transperineal group,the incidence of urinary retention was 6.9%and 7.3%,the incidence of rectal bleeding was 1.1%and 0%,respectively,with no statistically significant difference(P>0.05).After puncture,the incidence of infection was 9.1%an 1.5%the incidence of perineal swelling was 2.6%and 13.2%,respectively.There was a statistical difference between the two groups(P<0.05).Conclusion Ultrasound⁃guided transrectal and perineal prostate biopsy is an effective method for the diagnosis of prostate cancer.There was no significant differ⁃ence with the positive rates between groups,but each group had its own specific complication.