经直肠与超声引导下经会阴前列腺穿刺活检的比较

Comparison of DRE Guided Transrectal and Ultrasound Guided Transperineal Prostate Needle Biopsy

目的 :比较直肠指检引导下经直肠前列腺穿刺与超声引导下经会阴前列腺穿刺两种活检方法的阳性率和安全性。方法 :对 136例PSA >4ng /ml或直肠指检异常的患者进行前列腺穿刺活检 ,其中经直肠 2 2例 ,经会阴 114例。结果 :根据不同PSA水平及直肠指检结果分组 ,两组穿刺活检阳性率差异无统计学意义。超声引导下经会阴穿刺感染及便血发生率明显低于直肠指检引导下经直肠穿刺。结论 :直肠指检引导下经直肠前列腺穿刺和超声引导下经会阴前列腺穿刺都是进行前列腺活检的有效方法 ,应根据患者直肠指检、经直肠超声表现以及PSA水平选择穿刺方法 。

Objective: To compare the positive rate and safety between digital rectal examination (DRE) guided transrectal and ultrasound guided transperineal prostate needle biopsy. Methods: 136 patients underwent prostate biopsy who have either serum PSA above 4 ng /ml or abnormal findings of digital rectal examination. Among them 22 patients underwent DRE guided transrectal biopsy and 114 patients underwent transrectal ultrasound guided transperineal biopsy. Results: According to different PSA levels and DRE findings, there is no significant difference of positive rate between these two biopsy methods. But the infection and rectal bleeding rates of ultrasound guided transperineal biopsy are lower than transrectal biopsy. Conclusions: The two biopsy methods are both effective for diagnosis of prostate carcinoma. We should choose a proper biopsy method according to the findings of DRE, transrectal ultrasonography (TRUS) and PSA level. But transperineal biopsy is safer than transrectal biopsy.