同轴针在超声引导下经会阴自由手前列腺穿刺活检中的应用

Application of coaxial needle in ultrasound-guided transperineal free-hand prostate biopsy

目的 探讨将同轴针应用于超声引导下经会阴前列腺穿刺活检(TPB)的可行性、准确性及安全性。方法 选取我院2020年1月至2022年10月初次接受前列腺穿刺活检患者213例,随机分为同轴针组(经会阴同轴针引导取材)和经直肠组(经直肠穿刺架引导取材),术中依据视觉模拟评分(visual analog scale, VAS)评估患者穿刺疼痛程度,比较两组手术时间、VAS评分、阳性检出率及并发症的差异。结果 两组手术时间及VAS评分基本相当,差异无统计学意义(P>0.05)。两组总检出率分别为57.8%与54.8%,同轴针组检出率高于经直肠组,但差异无统计学意义(P>0.05)。同轴针组总并发症发生率低于经直肠组(P<0.05),差异有统计学意义。结论 将同轴针应用于超声引导下TPB,可以显著减少并发症,减轻患者术中疼痛,缩短手术时间,值得临床推广应用。

Objective To evaluate the feasibility,accuracy and safety of coaxial needle usage in ultrasound-guided transperineal prostate biopsy(TPB).Methods A total of 213 patients who underwent prostate biopsy for the first time in our hospital from January 2020 to October 2022 were enrolled in the study.They were randomly divided into the coaxial needle group(guided by perineal coaxial needle)and the transrectal group(guided by rectal puncture frame).VAS(visual analog scale)was used to evaluate the degree of pain during puncture.The differences in operation time,VAS score,positive rate and complications between the two groups were comparatively analyzed.Results The operation time and VAS score of the two groups were basically the same,there was no significant difference(P>0.05).The total positive rates of the two groups were 57.8%and 54.8%respectively.The positive rate of coaxial needle group was higher than that of transrectal group,but the difference was not statistically significant(P>0.05).The total complication rate of coaxial needle group was lower than that of transrectal group(P<0.05),and the difference was statistically significant.Conclusion Coaxial needle usage in ultrasound-guided TPB can significantly reduce complications,relieve the pain of patients during operation and shorten the operation time,which is worthy of clinical application.