摘要
目的:总结直肠超声引导下经会阴前列腺穿刺活检术的前列腺癌诊出率及安全性。方法:回顾性分析2015年1月—2019年12月河南省人民医院直肠超声引导下经会阴前列腺穿刺活检术患者的年龄、前列腺穿刺术前总前列腺特异抗原(tPSA)、游离前列腺特异抗原(fPSA)、临床病理、前列腺大小、穿刺并发症。结果:本研究共纳入1054例患者,平均年龄(69.25±8.88)岁;其中前列腺癌穿刺阳性582例(55.22%)。患者年龄越大,穿刺阳性率越高(P<0.05);术前tPSA水平越高,穿刺阳性率越高(P<0.05)。当tPSA水平处于4~10 ng/mL,前列腺穿刺阳性率为27.54%;当f/t<0.16,穿刺阳性率提高到39.77%,且f/t比值越低,穿刺阳性率越高(P<0.05);tPSA水平越高,患高危前列腺癌的可能性越大(P<0.05)。1054例患者术中及术后均未发生严重并发症,尿潴留、会阴小血肿、发热、血尿、疼痛的发生率分别为1.71%、2.18%、2.56%、36.32%、22.39%。结论:直肠超声引导下经会阴前列腺穿刺术具有诊出率高、并发症少的特点,值得临床推广。
Objective:To summarize the diagnostic rate and safety of transperineal prostate biopsy guided by rectal ultrasound.Methods:The clinical data of patients undergoing transperineal prostate biopsy guided by transrectal ultrasound in Henan Provincial People’s Hospital from January 2015 to December 2019 were retrospectively analyzed,including age,total prostate specific antigen(tPSA),free prostate specific antigen(fPSA),clinical pathology,prostate size and puncture complications.Results:A total of 1054 patients were included in this study,with an average age of(69.25±8.88)years old.Among them,582 cases(55.22%)were positive for prostate cancer.The results showed that the older the patient,the higher the positive rate of puncture(P<0.05).The higher the level of tPSA,the higher the positive rate of puncture(P<0.05).When tPSA was 4-10 ng/mL,the positive rate of prostate puncture was 27.54%.When f/t was less than 0.16,the positive rate of prostate puncture could be increased from 27.54%to 39.77%.The lower the ratio,the higher the positive rate of prostate puncture(P<0.05).The results showed that the higher the tPSA level,the higher the risk of prostate cancer(P<0.05).No serious complications occurred in 1054 patients during and after operation.The incidence of urinary retention,perineal hematoma,fever,hematuria and pain were 1.71%,2.18%,2.56%,36.32%and 22.39%respectively.Conclusion:The transperineal prostate puncture guided by rectal ultrasound has the characteristics of high diagnosis rate and less complications,which is worth popularizing.
作者
韩玉春
刘涛
刘建军
HAN Yuchun;LIU Tao;LIU Jianjun(Department of Urology,Henan University People’s Hospital,Henan Provincial People’s Hospital,Zhengzhou,450003,China;First Affiliated Hospital of Nanyang Medical College)
出处
《临床泌尿外科杂志》
CAS
2022年第6期466-469,共4页
Journal of Clinical Urology
