【摘要】 目的 对比超声引导下经会阴与经直肠途径在前列腺穿刺活检中的临床应用效果。方法 收集前列腺穿刺活检病例临床资料共378例，根据穿刺方法分为经会阴组和经直肠组，各189例。比较两组患者的前列腺特异性抗原（prostate specific antigen,PSA）水平及活检前列腺癌阳性率。同时根据PSA水平分为<10 ng/mL、10～30 ng/mL、>30ng/mL 3个层次，比较不同层次两组患者的活检阳性率。结果 两组活检前列腺癌阳性率在样本总体及不同PSA水平比较差异均无统计学意义（P> 0.05），且两组尿路刺激征、血尿、尿潴留等前列腺穿刺并发症的发生率比较差异无统计学意义（P> 0.05），而经会阴组的发热及出血率低于经直肠组，差异均有统计学意义（P <0.05）。结论 不同途径前列腺穿刺活检均安全有效，但经会阴途径的患者发热、出血风险较经直肠途径低。更多还原

【Abstract】 Objective:To compare the clinical value of ultrasound-guided transperineal and transrectal approaches in prostate biopsy. Methods:The clinical data of 378 prostate biopsy cases were collected,which were divided into transperineal group and transrectal group according to the puncture method,with 189 cases in each group. The PSA level and positive biopsy rate of the two groups were observed and compared. At the same time,PSA levels were divided into three levels:< 10ng/mL,10-30 ng/ml and > 30ng/ml,and the positive biopsy rates in different levels were compared between two groups. Results:There was no significant difference in the positive rate of biopsy between the perineal approach and the transrectal approach in the sample population and different PSA levels(P > 0. 05),and there was also no significant difference in the incidence of lower urinary tract irritation,hematuria,urinary retention and other prostate puncture complications between the two approaches(P > 0. 05). And the fever and bleeding rates of perineal route were lower than those of rectal route(P < 0. 05). Conclusion:Different methods of prostate biopsy are safe and effective,but the risk of fever and bleeding through perineal approach is lower than that through rectal approach.更多还原