日间手术模式下行前列腺周围神经阻滞下经会阴前列腺穿刺活检术可行性及安全性研究

Feasibility and safety of transperineal template-guided prostate biopsy under periprostatic nerve block in day operation mode

目的探讨日间手术模式下行前列腺周围神经阻滞下经会阴前列腺穿刺活检术(TTPB)的可行性及安全性。方法选取北部战区总医院自2021年7月至2022年7月收治的164例行前列腺周围神经阻滞下TTPB患者为研究对象。按照不同的住院模式将患者分为A组(n=80)与B组(n=84)。A组患者于住院模式下行TTPB,B组患者于日间手术模式下行TTPB。记录并比较两组患者围术期视觉模拟评分(VAS)、围术期相关指标、术后并发症发生情况。结果两组患者的VAS评分在前列腺尖部旁三角麻醉时、穿刺过程中、术后30 min时比较,差异均无统计学意义(P>0.05)。两组患者手术时间、患者满意度、术后并发症发生率比较,差异均无统计学意义(P>0.05);B组患者入院等待时间、住院时间,治疗总费用均少于A组,差异均有统计学意义(P<0.05)。A组、B组患者并发症发生率分别为9.5%(8/84)、10.0%(8/80),差异无统计学意义(P>0.05)。结论基于周围神经阻滞下的TTPB日间手术操作安全、诊断率确切,具有住院时间短、治疗费用低、院内感染风险低、并发症少及患者满意度高等优势。

Objective To investigate the feasibility and safety of transperineal template-guided prostate biopsy(TTPB)under periprostatic nerve block in day surgery mode.Methods A total of 164 patients with peripheral prostatic nerve block with TTPB treated in General Hospital of Northern Theater Command from July 2021 to July 2022 were selected as subjects.Patients were divided into group A(n=80)and group B(n=84)according to different hospitalization patterns.Patients in group A were treated with TTPB in inpatient mode,and patients in group B were treated with TTPB in day surgery mode.Perioperative visual analogue scale(VAS),perioperative related indexes and postoperative complications were recorded and compared between the two groups.Results There was no significant difference in VAS between the two groups during parapical triangle anesthesia,during puncture and 30 minutes after surgery(P>0.05).There were no significant differences in operation time,patient satisfaction and incidence of postoperative complications between two groups(P>0.05).The hospital admission waiting time,hospital stay and total treatment cost of group B were all lower than those of group A,with statistical significance(P<0.05).The incidence of complications in group A and group B were 9.5%(8/84)and 10.0%(8/80),respectively,with no statistical significance(P>0.05).Conclusion TTPB daytime surgery based on peripheral nerve block has the advantages of safe operation,accurate diagnosis rate,short hospital stay,low treatment cost,low risk of nosocomial infection,fewer complications,and high patient satisfaction.