经会阴前列腺饱和穿刺活检在前列腺癌诊断中的价值  

The value of transperineal ultrasound-guided saturation prostate biopsy protocols

作　　者：郭宝印[1] 李海波[1] 孙凤亮[1] 马超光[1] 闫成智 

机构地区：[1]天津市宝坻区人民医院泌尿外科,301800

出　　处：《中国现代医药杂志》2015年第5期40-43,共4页Modern Medicine Journal of China

摘　　要：目的：探讨经会阴前列腺饱和穿刺活检在前列腺癌诊断中的价值。方法按不同水平PSA（4.0~10.0ng/ml、10.0~20.0ng/ml、〉20.0ng/ml）比较经会阴前列腺饱和穿刺活检及经直肠前列腺穿刺活检的阳性率。对比经会阴前列腺饱和穿刺活检及经直肠前列腺穿刺活检术后肉眼血尿、发热、尿潴留、血便（直肠出血）、血管迷走神经反射、会阴不适（肿胀、出血）等并发症的发生率。结果与经直肠前列腺穿刺活检相比，经会阴前列腺饱和穿刺活检在PSA不同区间内阳性率明显升高，PSA〈20.0ng/ml的患者阳性率提高尤为明显。通过阳性率的比较，经会阴前列腺饱和穿刺活检的阳性率较经直肠前列腺穿刺活检阳性率明显升高，差异具有统计学意义。经会阴前列腺饱和穿刺活检术后肉眼血尿、发热及尿潴留等并发症的发生率低。结论经会阴前列腺饱和穿刺活检可以明显提高前列腺穿刺活检的阳性率，尤其对PSA〈20.0ng/ml的患者，阳性率提高更明显，且并发症发生率低，是一种安全有效的前列腺癌诊断方法。Objective To explore the value of saturated perineal prostate biopsy in the diagnosis of prostate cancer. Methods According to the PSA different interval （4.0~10.0ng/ml, 10.0~20.0ng/ml, 〉20.0ng/ml）, contrasted the positive rate of saturated perineal prostate biopsy and transrectal prostate biopsy.Compared the incidence of postoperative complications such as gross hematuria, fever, retention of urine, bloody stools, vasovagal reflex, perineum discomfort by saturated perineal prostate biopsy and transrectal prostate biopsy. Results Compared with transrectal prostate biopsy , the positive rate of saturated per-ineal prostate biopsy increased obviously in different PSA interval, especially with the patients that PSA level lower than 20ng/ml. The positive rate of saturated perineal prostate biopsy was higher than that of transrectal prostate biopsy , with statistical dif-ference. The incidence of complication such as gross hematuria , fever and retention of urine by saturated perineal prostate biopsy was low. Conclusion Saturated perineal prostate biopsy can improve the positive rate of prostate biopsy , especially for the patients whose PSA level is lower than 20ng/ml. It is a safe and effective diagnostic method for prostate cancer.

关 键 词：前列腺癌 经会阴前列腺饱和穿刺活检 经直肠前列腺穿刺活检 阳性率 并发症 

分 类 号：R737.25[医药卫生—肿瘤]