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目的:探讨15针经直肠超声引导下前列腺穿刺活检术诊断前列腺癌的临床价值及其安全性。方法:回顾性分析我院2010-01-10-2012-12-20 560例初次行经直肠超声引导下前列腺穿刺活检术的可疑前列腺癌患者的临床资料,对穿刺结果及穿刺后并发症情况做相关分析。结果:560例穿刺患者平均年龄(67.34±9.75)岁,平均前列腺特异性抗原(prostate specific antigen,PSA)水平为(8.41±33.45)μg/L,平均前列腺体积大小为(64.52±35.47)mL,穿刺结果为前列腺癌214例(38.2%),前列腺增生65例(11.6%),前列腺增生伴低级别上皮内瘤变(prostatic intraepithelialne oplasia,PIN)Ⅰ128例(22.9%),PINⅡ~Ⅲ35例(6.3%),良性前列腺增生(benign prostatic hyperplasia,BPH)伴慢性炎症96例(17.1%),腺泡状横纹肉瘤1例。穿刺术后119例出现肉眼血尿(21.3%),尿频、尿急和尿痛18例(3.2%),直肠出血3例(0.5%),急性尿潴留15例(2.7%),发热10例(1.8%),无其他严重并发症。结论:经直肠超声引导下前列腺15针系统穿刺法穿刺阳性率高,并发症少,是诊断前列腺癌的安全、有效方法,值得推广。
Objective: To investigate the clinical value and safety of 15-needle transrectal ultrasound-guided prostate biopsy in the diagnosis of prostate cancer. Methods: The clinical data of 560 patients with suspected prostate cancer undergoing transrectal ultrasound-guided prostatic biopsy in our hospital from January 2010 to October 2012 were retrospectively analyzed. The results of puncture and complication after puncture were correlated analysis. Results: The average age of the puncture patients was (67.34 ± 9.75) years old, the average PSA level was (8.41 ± 33.45) μg / L, the average prostate volume was (64.52 ± 35.47) mL, Prostate hyperplasia was found in 214 cases (38.2%) with prostatic hyperplasia, prostatic hyperplasia with low-grade prostatic intraepithelial neoplasia (121.98%), PINⅡ ~ Ⅲ %), Benign prostatic hyperplasia (BPH) with chronic inflammation in 96 cases (17.1%), alveolar striated sarcoma in 1 case. 119 cases of gross hematuria (21.3%), urinary frequency, urgency and dysuria in 18 cases (3.2%), rectal bleeding in 3 cases (0.5%), acute urinary retention in 15 cases (2.7% 1.8%), no other serious complications. Conclusion: The positive rate of puncture of prostate 15-needle system guided by transrectal ultrasound is high and there are few complications. It is a safe and effective method to diagnose prostate cancer and is worth promoting.