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目的:比较超声引导下经直肠与经会阴前列腺穿刺活检术诊断前列腺癌的安全性。方法:回顾性分析新疆维吾尔自治区人民医院及江西新余市人民医院2010年1月~2016年3月780例可疑前列腺癌患者初次行超声引导下经直肠与经会阴前列腺穿刺活检术的临床资料,对穿刺结果及穿刺后并发症情况做相关分析。结果:两组前列腺癌检出阳性率差异无统计学意义(P=0.846);两组患者年龄、前列腺体积、PSA值、体质指数及指诊异常均差异无统计学意义,手术时间差异有统计学意义。根据血清PSA水平分层比较血清PSA≤10μg/L及>10μg/L两组肿瘤检出率差异无统计学意义;根据前列腺体积分层比较在前列腺体积>50 ml时两组肿瘤检出率有统计学意义。两组在疼痛、血尿、便血、发热及菌血症方面差异有统计学意义。结论:两种前列腺穿刺方式肿瘤检出率相当、并发症少,是诊断前列腺癌的安全有效方法,在临床实践中可根据具体情况加以选择。
OBJECTIVE: To compare the safety of transrectal and transperineal prostate biopsy in the diagnosis of prostate cancer under ultrasound guidance. Methods: The clinical data of 780 patients with suspected prostate cancer underwent ultrasound-guided transrectal and transperineal prostate biopsy from January 2010 to March 2016 in People’s Hospital of Xinjiang Uygur Autonomous Region and People’s Hospital of Xinyu City in Jiangxi Province were retrospectively analyzed. Puncture results and post-puncture complications do related analysis. Results: There was no significant difference in the positive rates of prostate cancer between the two groups (P = 0.846). There was no significant difference in the age, prostate volume, PSA, body mass index and finger anomalies between the two groups Significance of learning. According to the level of serum PSA, serum PSA≤10μg / L and> 10μg / L were not significantly different between the two groups. According to the volume of prostate, when the volume of prostate was> 50ml, the detection rate was Statistical significance. The two groups had statistically significant differences in pain, hematuria, blood in the stool, fever and bacteremia. Conclusion: The two methods of prostatic puncture have the same detection rate and fewer complications, which is a safe and effective method to diagnose prostate cancer. In clinical practice, it can be selected according to the specific situation.