直肠超声引导下不同穿刺方案对前列腺癌确诊率、并发症及疼痛的影响

目的]比较在直肠超声(transrectal ultrasound,TRUS)引导下经会阴前列腺穿刺(TRUS-TP)及经直肠前列腺穿刺(TRUS-TR)对前列腺癌的确诊率、并发症及疼痛发生情况.方法]对本院收治的疑诊为前列腺癌的患者186例随机分为TRUS-TP组及TRUS-TR组,比较两种方法的确诊率、穿刺情况、感染致病菌分布等.结果]TRUS-TP组阳性检出率为37.63%(35/93),与TRUS-TR组35.48%(33/93)比较差异无统计学意义(P>0.05);TRUS-TP组术后轻度疼痛高于TRUS-TR组,轻度直肠出血发生率低于TRUS-TR组,其差异均有统计学意义(P<0.05),而其他指标比较差异无统计学意义(P>0.05);TRUS-TP组菌尿、菌血的发生率明显低于TRUS-TR组(P<0.05),两组患者发热、会阴部疼痛及下尿路症状的发生率比较差异无统计学意义(P>0.05);两组感染致病菌比较差异无统计学意义(P>0.05).结论]TRUS-TP和TRUS-TR两种穿刺方法对前列腺癌确诊率比较无差异,TRUS-TP虽然在穿刺术后疼痛程度较高,但其具有并发症少、感染率低等优势,值得临床推广应用.

Effect of Different Puncture Protocols on Diagnosis,Complications and Pain of Rectal Cancer Guided by Ultrasound

Objective] To compare transrectal ultrasound(transrectal ultrasound,TRUS)-guided trans-perineal prostate biopsy(TRUS-TP)and transrectal prostate biopsy(TRUS-TR)for prostate cancer diagnosis rate,complications and pain.Methods]A total of 186 patients with suspicious prostate cancer were randomly divided into TRUS-TP group and TRUS-TR group,and the diagnosis rate,puncture,pathogens distributiont of the two methods were compared.Results]The positive rate of TRUS-TP group was 37.63%(35/93), compared with TRUS-TR group 35.48%(33/93),the difference was not statistically significant(P >0.05);the postoperative mild pain in the group TRUS-TP was higher than that in the group TRUS-TR,and the inci-dence of mild rectal bleeding was lower than that in the group TRUS-TR,the difference was statistically sig-nificant(P <0.05),but there is no significant difference in other indexes(P >0.05);the incidence of bacte-riuria and bacterial blood in the group TRUS-TP was significantly lower than that in the group TRUS-TR(P<0.05).There was no significant difference in the incidence of fever,perineal pain and lower urinary tract symptoms between the two groups(P >0.05);there was no significant difference between the two groups of pathogenic bacteria(P >0.05).Conclusion]There was no difference between the two methods of TRUS-TP and TRUS-TR in the diagnosis of prostate cancer.Although TRUS-TP has higher pain level after puncture,it has the advantages of less complications and lower infection rate,which is worthy of clinical application.