超声引导下经直肠与经会阴途径前列腺穿刺活检术的比较

目的比较超声引导下经直肠与经会阴途径前列腺穿刺活检术在前列腺癌诊断中的效果。方法我院2015年12月~2018年12月超声引导下前列腺穿刺319例,其中经直肠162例(经直肠组),经会阴157例(经会阴组),比较2种穿刺活检方法阳性率、并发症发生率。结果经直肠与经会阴途径穿刺阳性率分别为31.5%(51/162)、35.7%(56/157),差异无统计学意义(χ^2=0.765,P=0.382)。2组穿刺后血尿、尿潴留、血管迷走神经反射发生率均无统计学意义(P>0.05)。经直肠组血便发生率14.2%(23/162),明显高于经会阴组1.9%(3/157)(χ^2=16.078,P=0.000);发热发生率9.9%(16/162),明显高于经会阴组2.5%(4/157)(χ^2=7.287,P=0.007);疼痛发生率3.7%(6/162),明显低于经会阴组10.2%(16/157)(χ^2=5.226,P=0.022)。结论直肠超声引导下经直肠与经会阴前列腺穿刺均为检测前列腺癌的有效途径,2种穿刺方法的阳性率相近,经会阴途径血便、发热发生率明显低于经直肠途径,疼痛发生率明显高于经直肠途径,应根据患者具体病情选择合理的穿刺方式。

Comparison of Ultrasound-guided Transrectal and Transperineal Prostate Biopsy

Objective To compare the effect of ultrasound-guided transrectal and transperineal prostate biopsy for prostate cancer.Methods From December 2015 to December 2018,there were 319 patients with ultrasound-guided prostate biopsy,including 162 patients with transrectal approach(transrectal group)and 157 patients with transperineal approach(transperineal group).The positive rate and complication rate were compared between the two groups.Results The positive rate of the transrectal group and transperineal group was 31.5%(51/162)and 35.7%(56/157),respectively,with no significant difference between the two groups(χ^2=0.765,P=0.382).There were no differences in the incidence of hematuria,urinary retention or vasovagal reflex between the two groups(P>0.05).The incidence of bloody stool was higher in the transrectal group(14.2%)than that in the transperineal group(1.9%,χ^2=16.078,P=0.000).The incidence of fever was higher in the transrectal group(9.9%)than that in the transperineal group(2.5%,χ^2=7.287,P=0.007).The incidence of pain was lower in the transrectal group(3.7%)than that in the transperineal group(10.2%,χ^2=5.226,P=0.022).Conclusions Ultrasound-guided transrectal and transperineal prostate biopsy are both effective ways.The detection rates of prostate cancer are similar between the two groups.The incidences of bloody stool and fever in the transperineal group are significantly lower than those in the transrectal group,while the incidence of pain in the transperineal group is significantly higher than that in the transrectal group.The selection of approaches should depend on patients’specific conditions.