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目的分析484例直肠超声导引下经会阴前列腺穿刺病例,以提高穿刺活检的阳性率。方法484例患者,以PSA>4ng/ml或肛指检查异常或B超发现异常回声为穿刺指征,行经会阴的6～8点系列加异常回声处活检。患者采取膀胱截石位,充分暴露会阴部。以1%利多卡因10ml作浸润麻醉,至前列腺包膜。随后用自动活检枪以6针系列穿刺法对前列腺双侧外周带各2针,移行带各1针。对B超发现的可疑处另穿刺数针。其中315例使用Aloka1700彩超仪和Promag2.2活检枪,另169例用ESAOTE TechrosMPS彩超仪和Bard Magmun活检枪。结果两组共484例,前列腺癌173例(35.7%),前列腺增生262例(54.1%),各级PIN35例(7.2%),不典型增生12例(2.8%),慢性肉芽肿性炎2例(0.4%)。Aloka组和ESAOTE组之间的阳性率比较无统计学上显著性差异。结论经会阴前列腺穿刺活检是一种并发症较轻,阳性率较高的前列腺肿瘤的诊断方法,且在不同B超仪和活检枪情况下可以达到相似的阳性率。
Objective To analyze 484 cases of perineal prostate puncture guided by rectal ultrasound to improve the positive rate of biopsy. Methods 484 patients with PSA> 4ng / ml or anal abnormalities or abnormal ultrasound findings of B-puncture indications, through the perineal 6 to 8 series plus abnormal echo biopsy. Patients with bladder lithotomy position, fully exposed perineum. To 1% lidocaine 10ml infiltration anesthesia, to the prostate capsule. Subsequent automatic biopsy gun with a 6-pin puncture on both sides of the prostate with the outer zone of the 2-pin, with a shift of 1 needle. Another suspicious Department of B-punctured the other needle punctured. Of these, 315 were Aloka 1700 and Promag 2.2 biopsy guns, and 169 were ESAOTE Techros MPS and Bard Magmun biopsy guns. Results There were 484 cases in both groups, including 173 cases of prostate cancer (35.7%), 262 cases of benign prostatic hyperplasia (54.1%), 35 cases of PIN35 (7.2%), 12 cases of atypical hyperplasia (2.8% Example (0.4%). There was no statistically significant difference in positive rates between the Aloka and ESAOTE groups. Conclusions Perineal prostatic biopsy is a diagnostic method for prostate cancer with lower complication and higher positive rate, and similar positive rates can be achieved under different B-mode and biopsy guns.