经直肠前列腺穿刺活检并发症分析及其防治

目的探讨经商肠前列腺穿刺活检并发症的发生率、相关因素和处理方法。方法对1995-2004年经直肠前列腺穿刺活检226例进行回顾性分析。由前列腺左右叶分别穿刺3点,中叶穿刺2点。干纱布置入直肠内压迫止血。穿刺前后各应用抗生素3d。结果穿刺后32例患者出现肉眼血尿(14．16％),12例患者直肠出血(5．31％),尿路刺激症状伴有／不伴有发热34例(15．04％),排尿困难29例(12．83％)。上述患者经相关处理后恢复。结论前列腺穿刺活检是诊断前列腺癌的一种安全、简便方法,但在应用中仍有可能发生各种并发症。使用细针穿刺和穿刺前充分的肠道准备是降低并发症发生率的有效手段。

Stduy on complications in diagnostic puncture of prostate via rectum

Objectives To explore the incidence, relative factors and management of the complications after the procedure of diagnostic puncture of prostate via rectum. Methods The complications of 226 patients who underwent prostate puncture biopsy via rectum were studied between 1995 and 2004 retrospectively. Three points at each of the right and left lobe and 2 points at the mid lobe were punctured.Dry gauze was then inserted into the rectum for compression hemostasis.Antibiotics was given 3 days before and after biopsy. Results Among the 226 patients, gross hematuria was found in 32 cases(14.16%),rectal bleeding in 12 cases(5.31%),lower urinary tract symptoms(LUTS) and/or fever in 34 cases(15.04%), difficult voiding in 29 cases(12.83%). All the patients with complications recovered after relative management. Conclusion Though puncture of prostate via rectum is considered simple and safe, some kind of complication may happen during the application. And the administration of thin puncture needle and intestine irrigation before biopsy are recommended to decrease the incidence of these complications.