CAJ | 학술논문

目的：比较经直肠6＋X点和14＋X点两种前列腺穿刺活检术的前列腺癌阳性检出率和并发症.方法回顾性分析384例经直肠前列腺穿刺活检病例资料.其中2007年1月至2009年4月采取经直肠手指引导下6＋X点前列腺穿刺活检共106例患者作为对照组；2009年5月至2014年12月采取经直肠彩超引导下14＋X点前列腺穿刺活检共278例患者作为观察组.结果对照组和观察组的前列腺癌阳性检出率分别为32．1％和47．5％，差异有统计学意义(P＜0．05).对照组手指触摸前列腺结节区和观察组彩超提示前列腺低回声区前列腺癌阳性检出率分别为86．4％和60．3％，差异有统计学意义(P＜0．05).对照组和观察组术后血尿发生率分别为11．3％和4．7％，差异有统计学意义(P＜0．05).两组患者术后直肠出血、感染发生率差异均无统计学意义(均P＞0．05).两组患者均无感染性休克、败血症、血管迷走神经反射等严重并发症出现.结论两种手术方式均安全、有效.与经直肠手指引导下6＋X点前列腺穿刺活检比较，经直肠彩超引导下14＋X点前列腺穿刺活检可以提高前列腺癌阳性检出率，但并发症并没有增加，值得推广.
목적：비교경직장6＋X점화14＋X점량충전렬선천자활검술적전렬선암양성검출솔화병발증.방법회고성분석384례경직장전렬선천자활검병례자료.기중2007년1월지2009년4월채취경직장수지인도하6＋X점전렬선천자활검공106례환자작위대조조；2009년5월지2014년12월채취경직장채초인도하14＋X점전렬선천자활검공278례환자작위관찰조.결과대조조화관찰조적전렬선암양성검출솔분별위32．1％화47．5％，차이유통계학의의(P＜0．05).대조조수지촉모전렬선결절구화관찰조채초제시전렬선저회성구전렬선암양성검출솔분별위86．4％화60．3％，차이유통계학의의(P＜0．05).대조조화관찰조술후혈뇨발생솔분별위11．3％화4．7％，차이유통계학의의(P＜0．05).량조환자술후직장출혈、감염발생솔차이균무통계학의의(균P＞0．05).량조환자균무감염성휴극、패혈증、혈관미주신경반사등엄중병발증출현.결론량충수술방식균안전、유효.여경직장수지인도하6＋X점전렬선천자활검비교，경직장채초인도하14＋X점전렬선천자활검가이제고전렬선암양성검출솔，단병발증병몰유증가，치득추엄.
Objective To compare the prostate cancer detection rate (PCDR)and complications of transrectal 6+X and 14+X core prostate biopsy. Methods We retrospectively analyzed 384 cases who underwent transrectal prostate biopsy for suspected prostate cancer.From January 2007 to April 2009,106 patients were given transrectal finger guided 6+X core prostate biopsy and chosen as con-trol group,the observation group include 278 patients who were given transrectal ultrasound guided 14+X core prostate biopsy between May 2009 and December 2014. Results The PCDR of the con-trol group was 32.1% (34/106),obviously lower than 47.5% (142/278)of the observation group (P<0.05).The PCDR of the prostate ultrasound hypoechoic area in observation group was 60.3%(47/78).However,the PCDR of the finger touch prostate nodule area in control group was 86.4%(19/22),which was higher than that of the observation group (P<0.05).The positive rate of hema-turia in the control group and observation group were 11.3% (12/106)and 4.7% (13/278),respec-tively.And the difference of the positive rate of hematuria between the two groups was statistically significant (P<0.05).The incidence rates of post biopsy infection and rectal bleeding of the two groups had no statistical significant difference (all P>0.05).Severe adverse reactions such as septic shock,sepsis,vasovagal reflex were not found in the two groups. Conclusions Transrectal finger guided 6+X core prostate biopsy and transrectal ultrasound guided 14+X core prostate biopsy are both safe and elfective for the diagnosis of prostate cancer.The latter can improve the PCDR without increasing complications.