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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Patients' tolerance and early complications of transrectal sonographically guided prostate biopsy: Prospective study of 300 patients.
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Patients' tolerance and early complications of transrectal sonographically guided prostate biopsy: Prospective study of 300 patients.

机译：经直肠超声引导下前列腺穿刺活检的患者耐受性和早期并发症：对300例患者的前瞻性研究。

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PURPOSE: To determine the degree of pain and discomfort associated with transrectal sonography (TRS)-guided biopsy of the prostate and to analyze the complications associated with this procedure. METHODS: Three hundred men referred as part of an investigation to exclude prostate cancer were studied. The reasons for referral were suspected prostate cancer due to increased serum prostate-specific antigen level (>4 ng/ml), the finding of a palpable nodule or greater firmness of one prostatic lobe than the other on digital rectal examination, or the finding of a suspicious area of neoplasm of the prostate on TRS biopsy. All TRS-guided biopsies were performed as outpatient procedures without anesthesia. Ciprofloxacin prophylaxis was used in all patients before biopsy. Tolerance of the procedure was recorded immediately after the examination and graded on a scale of 0-4 as follows: 0, no pain; 1, very mild pain; 2, moderate pain; 3, severe pain; 4, intolerable pain. Complications recorded in the first week after the procedure were analyzed. They included mild pain, self-limiting hematuria, hematospermia, rectal bleeding, severe hematuria, septicemia, severe hemorrhage of the anus, and vasovagal attack. RESULTS: Out of 300 TRS-guided biopsies, 10 early complications were recorded. The most frequent was septicemia, which was seen in 5 cases (1.7%). Hematuria occured in 29 patients, 3 of which were severe. Rectal bleeding and vasovagal attack occurred in 1 patient each. All patients made a full recovery with appropriate conservative management. Ten cases (3.33%) of severe pain (grade 3) and intolerable pain (grade 4) were observed. Three out of these 10 patients completed the procedure. The procedure was terminated in 1 patient, and 6 patients required local anesthetic due to perianal disease. CONCLUSIONS: TRS-guided prostate biopsy can be performed without local anesthesia in 90% of patients. Prophylactic antibiotics are mandatory to minimize approximately infectious complications. (c) 2005 Wiley Periodicals, Inc. J Clin Ultrasound 33:452-456, 2005.
机译：目的：确定经直肠超声（TRS）引导的前列腺活检所引起的疼痛和不适程度，并分析与该手术相关的并发症。方法：对三百名男性进行调查以排除前列腺癌的研究。转诊的原因是由于血清前列腺特异性抗原水平升高（> 4 ng / ml），在前列腺直肠指检中发现一个明显的结节或一个前列腺比另一个前列腺更牢固而怀疑前列腺癌。 TRS活检中前列腺肿瘤的可疑区域。所有TRS指导的活检均作为门诊手术进行，无麻醉。活检前所有患者均使用环丙沙星预防。检查后立即记录手术的耐受性，并按0-4的等级评分：0，无疼痛; 1，非常轻微的疼痛; 2，中度疼痛; 3，剧烈疼痛; 4，难以忍受的痛苦。分析手术后第一周记录的并发症。它们包括轻度疼痛，自限性血尿，血精症，直肠出血，严重血尿，败血病，肛门严重出血和血管迷走神经发作。结果：在300份TRS引导的活检中，记录了10例早期并发症。最常见的是败血病，其中5例（1.7％）被发现。血尿发生在29例患者中，其中3例是严重的。直肠出血和血管迷走神经发作各发生1例。通过适当的保守治疗，所有患者均完全康复。观察到十例（3.33％）严重疼痛（3级）和无法忍受的疼痛（4级）。这10名患者中有3名完成了手术。 1例患者终止了该手术，由于肛周疾病，有6例患者需要局部麻醉。结论：TRS引导的前列腺活检可在90％的患者中进行而无需局部麻醉。必须使用预防性抗生素以最大程度地减少传染性并发​​症。 （c）2005 Wiley Periodicals，Inc. J Clin Ultrasound 33：452-456，2005。

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