本文選題：前列腺癌 + 穿刺活檢��； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的：比較超聲引導(dǎo)下經(jīng)直腸前列腺6針、10針、12針?lè)ɑ顧z穿刺診斷前列腺癌的差異，并根據(jù)具體情況選擇較合理的前列腺穿刺活檢方案。 方法：回顧性分析研究2009年1月—2013年12月期間初步診斷為前列腺癌的病人278例，分別接受6針、10針或12針前列腺穿刺活檢，其中126例患者接受6針?lè)ù┐袒顧z，102例接受10針?lè)ù┐袒顧z，50例接受12針?lè)ù┐袒顧z。患者年齡為43~90歲，平均71歲；PSA水平為0.1~106.1ng/ml，平均40.9ng/ml；前列腺體積為12.5~162.7ml，平均60.2ml；依照穿刺結(jié)果，對(duì)比研究6針、10針和12針穿刺法的陽(yáng)性檢出率。應(yīng)用統(tǒng)計(jì)學(xué)方法對(duì)三種穿刺方案在患者年齡、PSA、前列腺體積、穿刺數(shù)量、穿刺部位及直腸檢查等方面進(jìn)行統(tǒng)計(jì)分析，并統(tǒng)計(jì)不同穿刺部位陽(yáng)性率的差異。 結(jié)果：6針、10針、12針?lè)ù┐痰年?yáng)性率分別為42.9%（54/126）、58.8%（60/102）、62.0%（31/50）。與6針?lè)ㄏ啾龋?0針?lè)ê?2針?lè)ǚ謩e使總體陽(yáng)性率提高15.9%、19.1%，而12針?lè)ǹ傮w陽(yáng)性率僅比10針?lè)ㄌ岣?.2%。10針?lè)ㄅc6針?lè)ㄏ啾�，在年齡70歲、40ml≤前列腺體積90ml、PSA40ng／ml、DRE陰性的患者中，陽(yáng)性率差異更為顯著，而12針?lè)ㄅc10針?lè)ㄏ啾�，，僅僅在患者前列腺體積≥90ml時(shí)，陽(yáng)性率才有明顯的不同。145例陽(yáng)性病例共穿刺1296針，陽(yáng)性針數(shù)768針，陽(yáng)性率59.3%。三種方法穿刺后并發(fā)癥發(fā)生率無(wú)明顯差異。 結(jié)論：增加穿刺針數(shù)，前列腺癌的總體陽(yáng)性率會(huì)隨之提高。選擇何種穿刺方法，應(yīng)根據(jù)患者具體情況靈活掌握。當(dāng)患者年齡70歲、PSA≤40ng/ml、40ml≤前列腺體積90ml、直腸指檢陰性時(shí)，采取10針?lè)ù┐梯^為適宜。當(dāng)患者年齡≥70歲、PSA小于40ng/ml、前列腺體積40ml、直腸指檢陽(yáng)性時(shí)，采取6針?lè)ù┐梯^為適宜。當(dāng)患者前列腺體積≥90ml時(shí)，其他任意情況下，應(yīng)采取12針?lè)ù┐�。增加穿刺針�?shù)并沒(méi)有明顯增加并發(fā)癥的發(fā)生率。
[Abstract]:Objective: to compare the difference of transrectal prostate biopsy guided by ultrasound in diagnosis of prostate cancer with 6 or 10 or 12 needle biopsies, and to select a more reasonable prostatic biopsy scheme according to the specific conditions. Methods: a retrospective study of 278 patients with prostate cancer from January 2009 to December 2013 was performed. Among them, 126 patients received 6 needle biopsy and 102 received 10 needle biopsy and 50 received 12 needle biopsy. The age of the patients was 430.90 years old (mean 71 years old), the PSA level was 0.1 ~ 106.1 ng / ml with an average of 40.9 ng / ml, and the prostate volume was 12.5 ~ 162.7 ml, with an average of 60.2 ml. According to the puncture results, the positive rates of 10 and 12 needle puncture methods were compared and studied. Three kinds of puncture methods were used to analyze the patient's age, prostate volume, puncture quantity, puncture site and rectal examination, and the difference of positive rate among different puncture sites was analyzed. Results the positive rates of the needle puncture were 42.9%, 58.8%, 62.0% and 31 / 50, respectively. Compared with the 6 acupuncture method, the total positive rate was increased by 15. 9% and 19. 1%, respectively, while the total positive rate of 12 acupuncture method was only 3. 2% higher than that of the 10 acupuncture method. Compared with the 6 acupuncture method, the total positive rate of 12 acupuncture method was only 3. 2% higher than that of the 6 acupuncture method. In the patients aged 70 years with 40 ml 鈮

本文編號(hào)：1921811