超声引导下局部浸润麻醉经会阴前列腺穿刺活检的临床应用

Clinical Application of Transperineal Prostate Biopsy with Local Infiltration Anesthesia by Ultrasound-guided

目的:探讨超声引导下局部浸润麻醉经会阴前列腺穿刺活检的应用效果。方法:选取2017年7月-2019年7月本院需行前列腺穿刺活检的92例患者,将其按随机数字表法分为经会阴穿刺活检组和经直肠穿刺活检组,各46例。经会阴穿刺活检组给予超声引导下局部浸润麻醉经会阴前列腺穿刺活检,经直肠穿刺活检组给予超声引导下经直肠前列腺穿刺活检。比较两组穿刺针数、前列腺癌检出率、疼痛程度及并发症发生情况。结果:两组穿刺针数和前列腺癌检出率比较,差异均无统计学意义(P>0.05)。经会阴穿刺活检组无痛和轻度疼痛率均高于经直肠穿刺活检组,且中重度疼痛率低于经直肠穿刺活检组(P<0.05)。经会阴穿刺活检组发热、血尿、血便、尿潴留及菌血症发生率均低于经直肠穿刺活检组(P<0.05)。结论:超声引导下局部浸润麻醉经会阴前列腺穿刺活检可明显缓解患者疼痛程度,有效降低并发症的发生。

Objective:To investigate the effect of transperineal prostate biopsy with local infiltration anesthesia by ultrasound-guided.Method:A total of 92 patients requiring prostate biopsy in our hospital from July 2017 to July 2019 were selected.According to the random number table method,they were divided into transperineal puncture biopsy group and transrectal puncture biopsy group,with 46 cases in each group.The transperineal puncture biopsy group was given transperineal prostate biopsy with local infiltration anesthesia by ultrasoundguided.The transrectal puncture biopsy group was given transrectal puncture biopsy by ultrasound-guided.The times of puncture,prostate cancer detection rate,pain degree and complications were compared between the two groups.Result:There were no significant difference in the times of puncture and the detection rate of prostate cancer between the two groups(P>0.05).The rates of no pain and mild pain in the transperineal biopsy group were higher than those in the transrectal biopsy group,and the rates of moderate and severe pain were lower than those in the transrectal biopsy group(P<0.05).The incidence of fever,hematuria,blood stool,urinary retention and bacteremia in the transperineal biopsy group were lower than those in the transrectal biopsy group(P<0.05).Conclusion:The transperineal prostate biopsy with local infiltration anesthesia by ultrasound-guided can significantly relieve the pain degree of patients and effectively reduce the incidence of complications.