超声造影精准穿刺在经直肠前列腺穿刺活检中的应用

何佳; 刘宁; 于田强; 时开元; 段跃

doi:10.16766/j.cnki.issn.1674-4152.003258

超声造影精准穿刺在经直肠前列腺穿刺活检中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003258

何佳^1, ,,
刘宁²,
于田强¹,
时开元³,
段跃⁴

1.
浙江省荣军医院泌尿外科，浙江嘉兴 314000
2.
浙江省荣军医院超声介入科
3.
浙江省肿瘤医院超声介入科，浙江杭州 310022
4.
浙江中医药大学附属第二医院泌尿外科，浙江杭州 310005

基金项目:

浙江省基础公益研究计划项目 LY20H270003

嘉兴市科技计划项目 2020AD30003

详细信息

通讯作者:
何佳，E-mail：zjrjyyhj@163.com

中图分类号: R446.8R737.25
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- 文章访问数: 64
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- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2023-06-06
- 网络出版日期: 2024-01-13

Application of contrast-enhanced ultrasound precise puncture in transrectal prostate biopsy

1.
Urology Department, Rongjun Hospital of Zhejiang Province, Jiaxing, Zhejiang 314000, China

摘要

摘要: 目的研究超声造影精准穿刺在经直肠前列腺穿刺活检中的应用效果, 旨在提高穿刺阳性率、减轻患者痛苦, 为临床诊治提供依据。方法选择2019年7月-2022年12月浙江省荣军医院收治的150例前列腺特异性抗原(PSA)升高、前列腺结节患者, 按照随机数表法分为对照组(75例)与观察组(75例), 2组均行经直肠前列腺穿刺活检, 对照组于常规超声引导下穿刺, 观察组于超声造影下精准穿刺。每组按PSA值分4个区间, 第一组: 4 ng/mL < PSA≤10 ng/mL; 第二组: 10 ng/mL < PSA≤20 ng/mL; 第三组: 20 ng/mL < PSA≤40 ng/mL; 第四组: PSA>40 ng/mL。比较2组患者相关指标、不良反应发生情况, 以及4个区间穿刺活检病理的恶性检出率。结果观察组穿刺针数与对照组相近(P>0.05);阳性针数[(1.84±0.52)针]、Gleason评分[(7.25±1.22)分]高于对照组[(1.56±0.41)针、(6.32±1.06)分, 均P < 0.05]。观察组不良反应发生率(9.33%, 7/75)低于对照组(46.67%, 35/75, P < 0.05)。观察组的恶性检出率(52.00%, 39/75)高于对照组(34.67%, 26/75, P < 0.05)。2组不同PSA区间穿刺活检病理的恶性检出率比较差异有统计学意义(P < 0.05)。结论超声造影精准穿刺在经直肠前列腺穿刺活检中应用效果较好, 可提高穿刺阳性率与前列腺癌检出率, 且能减少不良反应, 值得推广。
- 超声造影 /
- 精准穿刺 /
- 经直肠前列腺穿刺活检 /
- 前列腺癌 /
- 诊断
Abstract: Objective To study the application effect of contrast-enhanced ultrasound precise puncture in transrectal prostate biopsy, aiming to improve the puncture positive rate, reduce patient pain, and provide a basis for clinical diagnosis and treatment. Methods A total of 150 patients with elevated prostate specific antigen (PSA) and prostate nodules admitted to the Rongjun Hospital of Zhejiang Province from July 2019 to December 2022 were selected and divided into control group (75 cases) and observation group (75 cases) according to the random number table method.Both groups underwent transrectal prostate biopsy, the control group undergoing routine ultrasound guided puncture, while the observation group undergoing precise ultrasound contrast-enhanced puncture.Each group was divided into four intervals based on PSA values, the first group: 4 ng/mL < PSA≤ 10 ng/mL; the second group: 10 ng/mL < PSA≤20 ng/mL; the third group: 20 ng/mL < PSA≤40 ng/mL; the fourth group: PSA>40 ng/mL.The related indicators (number of puncture needles, number of positive needles, Gleason score), incidence of adverse reactions (slight hematuria, fever, rectal bleeding, urinary retention, dysuria), and malignant detection rate of biopsy pathology in four regions were compared between the two groups. Results The number of puncture needles in the observation group was similar to that in the control group (P>0.05).The number of positive needles[(1.84±0.52) needles]and Gleason score[(7.25±1.22) points]were higher than those in the control group[(1.56±0.41) needles, (6.32±1.06) points, both P < 0.05].The incidence of adverse reactions in the observation group (9.33%, 7/75) was lower than that in the control group (46.67%, 35/75, P < 0.05).The malignant detection rate in the observation group (52.00%, 39/75) was higher than that in the control group (34.67%, 26/75, P < 0.05).The difference in malignant detection rate of puncture biopsy pathology between different zones in the 2 groups was statistically significant (P < 0.05). Conclusion The application of contrast-enhanced ultrasound precise puncture in transrectal prostate biopsy has a good effect, can improve the positive rate of puncture and the detection rate of prostate cancer, and can reduce adverse reactions, which is worthy of application.
- Contrast-enhanced ultrasound /
- Accurate puncture /
- Transrectal prostate biopsy /
- Prostate cancer /
- Diagnosis

HTML全文

表 1 2组经直肠前列腺穿刺活检患者穿刺相关指标比较(x±s)

Table 1. Comparison of relevant indexes between two groups of patients with transrectal prostate biopsy (x±s)

组别	例数	穿刺针数 (针)	阳性针数 (针)	Gleason 评分(分)
对照组	75	12.14±1.78	1.56±0.41	6.32±1.06
观察组	75	12.59±1.70	1.84±0.52	7.25±1.22
t值		1.583	3.662	4.983
P值		0.115	＜0.001	＜0.001

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表 2 2组经直肠前列腺穿刺活检患者不良反应发生情况比较

Table 2. Comparison of the occurrence of adverse reactions between two groups of patients with transrectal prostate biopsy

组别	例数	轻微血尿 (例)	发热 (例)	直肠出血 (例)	尿潴留 (例)	排尿困难 (例)	总发生 [例(%)]
对照组	75	21	4	4	3	3	35(46.67)
观察组	75	4	1	1	1	0	7(9.33)
注：2组不良反应总发生率比较，χ²=25.926，P＜0.001。

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表 3 2组经直肠前列腺穿刺活检患者恶性检出率比较

Table 3. Comparison of malignant detection rates between two groups of patients with transrectal prostate biopsy

组别	例数	恶性例数	恶性检出率 (%)	组别	例数	恶性例数	恶性检出率 (%)
对照组	75	26	34.67	观察组	75	39	52.00
第一组	36	9	25.00	第一组	35	14	40.00
第二组	21	7	33.33	第二组	22	11	50.00
第三组	12	6	50.00	第三组	11	8	72.73
第四组	6	4	66.67	第四组	7	6	85.71
Z值			7.256	Z值			11.533
P值			＜0.001	P值			＜0.001
注：2组恶性检出率比较，χ²=4.588，P=0.032。

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