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经会阴饱和穿刺与传统前列腺穿刺活检法诊断前列腺癌对比分析

薛健1,梁磊2,刘忠泽3,杨春生3   

  1. 1. 北京市仁和医院男科
    2. 北京市普仁医院泌尿外科
    3. 北京市仁和医院泌尿外科
  • 收稿日期:2012-09-19 修回日期:2012-12-12 出版日期:2013-09-15 发布日期:2013-09-15
  • 通讯作者: 梁磊

Comparative Analysis of transperineal saturated prostate biopsy with traditional prostate biopsy modes

  • Received:2012-09-19 Revised:2012-12-12 Published:2013-09-15 Online:2013-09-15
  • Contact: Lei LIANG

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摘要：

【摘要】 目的  评价经会阴饱和穿刺与传统前列腺穿刺活检法在前列腺癌诊断中的临床价值。 方法  355例行前列腺穿刺患者，其中经直肠穿刺(A)组110例，经会阴12针穿刺(B)组144例，经会阴24针穿刺(C)组101例，对比3组在不同前列腺特异性抗原（PSA）水平上的穿刺阳性率、并发症的发生率以及手术时间和住院时间等指标。 结果   PSA<10.0μg/L者中，C组的阳性率(32.3%)明显高于A组（10.8%）和B组（13.0%）；PSA在10.0~60.0μg/L和PSA>60.0μg/L者中，3组阳性率差异无统计学意义；A组肉眼血尿、发热、血便等并发症发生率明显高于B组和C组；A组手术时间和住院时间最短。 结论  直肠超声引导下经会阴24针穿刺法不但穿刺阳性率高，而且安全性好、并发症少，是一种理想的前列腺癌诊断方法。

关键词: 前列腺, 前列腺肿瘤, 会阴, 直肠, 活组织检查, 穿刺术

Abstract: Objective: To evaluate the clinical value of different prostate biopsy modes for the diagnosis of prostate cancer. Methods: Analyzed the clinical data of 355 cases that underwent prostate biopsy. 110 cases (group A) received transrectal prostate biopsy. 144 cases (group B) received 12-core transperineal prostate biopsy and 101 cases (group C) received 24-core transperineal prostate biopsy. Compare the positive rates and complication rates of three groups in different PSA levels. Results: The positive rate of biopsy with PSA<10.0ng/ml in group C was 32.3%, which was higher than that of group A (10.8%) and group B (13.0%). The positive rates of biopsy with PSA10.0-60.0ng/ml or PSA>60.0ng/ml of the three groups had no statistics significance. The complication rates of gross hematuria, fever, bloody stool in group A were significantly higher than that in group B and group C. Group A had advantages in operating time, hospitalization time and cost (P<0．05). Conclusions: The ideal method for the diagnosis of prostate cancer is the TRUS guided 24-core transperineal prostate biopsy, which has high diagnostic accuracy, safety and fewer complications.