摘要
目的探讨局部麻醉下经会阴超声磁共振图像融合前列腺靶向穿刺活检术在门诊诊室操作的可行性、安全性。方法2018年9月至2019年5月,共纳入608例患者,所有患者均在穿刺前行多参数磁共振检查(mpMRI),并在门诊诊室局部麻醉下接受靶向穿刺和系统穿刺。结果608例患者的平均年龄为(66.8±7.4)岁,穿刺前血清总前列腺特异性抗原(PSA)平均为(8.1±4.1)ng/mL。检出前列腺癌306例(50.3%),临床有意义前列腺癌(csPCa)268例(44.1%)。单独靶向穿刺或单独系统穿刺都将漏检较多的PCa。整个前列腺穿刺平均耗时(15.9±4.9)min。疼痛较易忍受,无患者因疼痛放弃穿刺。最常见的穿刺并发症是血尿(52.1%),无脓毒血症发生。40 d内基础排尿和勃起功能无明显变化。结论在局部麻醉下,诊室化行经会阴图像融合前列腺穿刺靶向活检术是安全、可行的。
Objective To investigate the feasibility and safety of MRI targeted transperineal prostate biopsy under local anesthesia.Methods From Sep.2018 to May 2019,we enrolled 608 patients who underwent multi-parameter MRI(mpMRI)prior to biopsy.All patients received targeted biopsy and systematic biopsy under local anesthesia in the outpatient clinic.Results The patients mean age was(66.8±7.4)years,and total serum prostate specific antigen(PSA)before biopsy was(8.1±4.1)ng/mL.Prostate cancer was detected in 306(50.3%)cases and 268(44.1%)patients were diagnosed with clinically significantly prostate cancer(csPCa).Targeted biopsy alone or systematic biopsy alone missed some PCa cases.Prostate biopsy took(15.9±4.9)min in average.The pain was tolerable.No patients gave up due to intolerable pain.Hematuria was the most common complication(52.1%).No sepsis was observed.There were no significant changes in urination or erectile function within 40 days.Conclusion Under local anesthesia,MRI targeted transperineal prostate biopsy is safe and feasible.
作者
庄君龙
阚延晟
尹皓立
汪维
郭宏骞
ZHUANG Junlong;KAN Yansheng;YIN Haoli;WANG Wei;GUO Hongqian(Department of Urology,Nanjing Drum Tower Hospital,Medical School of Nanjing University,Nanjing 210008,China)
出处
《现代泌尿外科杂志》
CAS
2021年第4期293-296,327,共5页
Journal of Modern Urology
基金
江苏省卫计委青年基金(No.Q2017005)。
关键词
局部麻醉
经会阴穿刺
诊室化操作
靶向穿刺
前列腺癌
Local anesthesia
transperineal biopsy
clinic operation
targeted biopsy
prostate cancer
