经会阴前列腺穿刺活检医院感染原因分析  

Causes of nosocomial infections induced by transperineal prostate biopsy

作　　者：方建华[1] 孔凡雷[1] 王炜[1] 徐陈柯[1] 陈创华[1] 王旭亮[1] 许亮[1] 

机构地区：[1]杭州市第一人民医院超声影像科,浙江杭州310006

出　　处：《中华医院感染学杂志》2014年第21期5373-5375,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技基金资助项目(2011KYB064)

摘　　要：目的探讨直肠超声引导下经会阴前列腺穿刺活检发生医院感染等并发症的原因和防治措施,从而减少前列腺穿刺感染率。方法回顾性分析1995年6月-2012年12月在医院超声介入科行直肠超声引导下经会阴部前列腺穿刺活检患者1 568例临床资料,分析引发感染等并发症的相关因素及防治措施。结果发生感染98例,感染率6.25%,出现肉眼血尿294例、尿潴留65例、血管迷走神经反射、血尿合并血精19例、发热12例、会阴部肿胀伴出血9例,发生率分别为18.75%、4.15%、1.66%、1.21%、0.77%、0.57%;发生并发症患者的穿刺次数多于无并发症患者,穿刺针外径大于无并发症患者,差异均有统计学意义(P<0.01)。结论经直肠超声引导下经会阴部前列腺穿刺活检是早期诊断前列腺癌的安全有效的方法,穿刺后出现感染等并发症与穿刺次数及穿刺针粗细有很大的关系,合理的穿刺次数和穿刺针外径是降低这些并发症发生的重要因素。OBJECTIVE To explore the causes of complications induced by the transrectal ultrasound-guided trans-perineal prostate biopsy and put forward prevention measures so as to reduce the incidence of infections caused by the transperineal prostate biopsy .METHODS A total of 1 568 patients who underwent the transrectal ultrasound-guided transperineal prostate biopsy in the ultrasound interventional department from Jun 1995 to Dec 2012 were enrolled in the study ,then the clinical data of the enrolled patients were retrospectively analyzed ,the related fac-tors for the complications such as nosocomial infections were analyzed ,and the prevention measures were put for-ward .RESULTS The nosocomial infections occurred in 98 cases with the infection rate of 6 .25% ,gross hematuria in 294 cases ,urinary retention in 65 cases ,vasovagal reflex ,hematuria complicated with hematospermia in 19 ca-ses ,fever in 12 cases , perineal swelling complicated with bleeding in 9 cases , and the incidence rates were 18 .75% ,4 .15% ,1 .66% ,1 .21% ,0 .77% ,and 0 .57% ,respectively .The frequency of puncture of the patients with complications was higher than that of those without complications ,the external diameter of the puncture nee-dle of the patients with complication was greater than that of the patients without complications ,there was statis-tically significant difference （P〈0 .01） .CONCLUSION The transrectal ultrasound-guided transperineal prostate bi-opsy is a safe and effective way to diagnose prostate cancer in early stage ,the complications such as the infections , to great extent ,are associated with the frequency of puncture and the size of the puncture needle ,and reasonable frequency of puncture and appropriate size of puncture needle may contribute to the reduction of incidence of the complications .

关 键 词：直肠超声 经会阴部 前列腺穿刺 感染 并发症 防治措施 

分 类 号：R181.32[医药卫生—流行病学]