前列腺癌穿刺活检后并发症及其相关影响因素的研究进展
摘要
biopsy,PB)。然而,PB术后可能出现出血、尿潴留、疼痛及感染等并发症,影响患者的生活质量和后续治疗。本综
述探讨了前列腺穿刺活检术后并发症的影响因素。研究发现,出血与穿刺途径、穿刺针数、抗凝药物使用等因素相
关;尿潴留的发生与前列腺体积、活检针数及穿刺途径有关;疼痛与年龄、前列腺体积、麻醉方式、焦虑等因素相
关;感染则主要与穿刺途径、穿刺针数、肠道准备及抗生素使用有关。经直肠穿刺(Transrectal prostate biopsy,TR)
虽操作简便,但感染风险较高,尤其是耐药菌感染增加;经会阴穿刺(Transperineal prostate biopsy,TP)感染风险低,
但疼痛发生率较高。综合来看,临床应根据患者具体情况选择合适的穿刺方案,并优化预防措施,以降低术后并发
症的发生率,提高患者的生活质量和治疗效果。
关键词
全文:
PDF参考
[1]Sung H, Ferlay J, Siegel R L, et al. Global Cancer
Statistics 2020: GLOBOCAN Estimates of Incidence and
Mortality Worldwide for 36 Cancers in 185 Countries[J]. CA
Cancer J Clin, 2021,71(3):209-249.DOI:10.3322/caac.21660.
[2]顾 秀 瑛, 郑 荣 寿, 张 思 维, 等.2000—2014年
中国肿瘤登记地区前列腺癌发病趋势及年龄变化分析
[J].中华预防医学杂志,2018,52(6):586-592.DOI:
10.3760/cma.j.issn.0253-9624.2018.06.006.
[3]闵淑慧,胡依,郭芮绮,等.1990—2019年中国
前列腺癌疾病负担分析及趋势预测[J].中国肿瘤,2023,
32(03):171-177.
[4]郝文哲,陈东,卢宁宁,等.2023年度前列腺癌
诊疗研究进展[J].肿瘤综合治疗电子杂志,2024,10(02):
28-45.
[5]Quinlan M R, Bolton D, Casey R G. The
management of rectal bleeding following transrectal prostate
biopsy: A review of the current literature[J]. Can Urol Assoc J,
2018,12(3):E146-E153.DOI:10.5489/cuaj.4660.
[6]Dave N, Esmail K G R, Gonzalez H H, et al.
Hemorrhagic Shock After Transrectal Ultrasound-Guided
Prostate Biopsy Successfully Treated With Endoscopic
Therapy[J]. ACG Case Rep J, 2023,10(4):e1027.
DOI:10.14309/crj.0000000000001027.
[7]Malik A, Ishtiaq R, Goraya M, et al. Endoscopic
Therapy in the Management of Patients With Severe
Rectal Bleeding Following Transrectal Ultrasound-Guided
Prostate Biopsy: A Case-Based Systematic Review[J]. J
Investig Med High Impact Case Rep, 2021,9:1605860950.
DOI:10.1177/23247096211013206.
[8]Borghesi M, Ahmed H, Nam R, et al. Complications
After Systematic, Random, and Image-guided Prostate
Biopsy[J]. Eur Urol, 2017,71(3):353-365.DOI:10.1016/
j.eururo.2016.08.004.
[9]Kum F, Jones A, Nigam R. Factors influencing urinary
retention after transperineal template biopsy of the prostate:
outcomes from a regional cancer centre[J]. World J Urol,
2019,37(2):337-342.DOI:10.1007/s00345-018-2390-8.
[10]Sandberg M, Whitman W, Greenberg J, et al.
Risk factors for infection and acute urinary retention
following transperineal prostate biopsy[J]. Int Urol Nephrol,
2024,56(3):819-826.DOI:10.1007/s11255-023-03854-0.
[11]Alhamdani Z, Poppenbeek S, Bolton D, et al. Do alpha
blockers reduce the risk of urinary retention post-transperineal
prostate biopsy? A systematic narrative review[J]. World J Urol,
2024,42(1):332.DOI:10.1007/s00345-024-05001-5.
[12]Skouteris V M, Crawford E D, Mouraviev V, et al.
Transrectal Ultrasound-guided Versus Transperineal Mapping
Prostate Biopsy: Complication Comparison[J]. Rev Urol,2018,20(1):19-25.DOI:10.3909/riu0785.
[13]Berry B, Parry M G, Sujenthiran A, et al.
Comparison of complications after transrectal and transperineal
prostate biopsy: a national population-based study[J]. BJU
Int, 2020,126(1):97-103.DOI:10.1111/bju.15039.
[14]江洪澜,王金国,曹彦明,等.经直肠前列腺穿
刺活检的疼痛产生和麻醉控制选择[J].中国老年学杂志,
2019,39(12):3084-3087.
[15]李鑫,毕国风,徐阳,等.经会阴前列腺穿刺
活检术疼痛风险评估模型的构建[J].中国男科学杂志,
2024,38(01):62-69.
[16]Marra G, Zhuang J, Marquis A, et al. Pain in Men
Undergoing Transperineal Free-Hand Multiparametric
Magnetic Resonance Imaging Fusion Targeted Biopsies under
Local Anesthesia: Outcomes and Predictors from a Multicenter
Study of 1,008 Patients[J]. J Urol, 2020,204(6):1209-1215.
DOI:10.1097/JU.0000000000001234.
[17]丁可珂,徐振宇,张杰,等.直肠腔内局部麻醉
和前列腺周围神经阻滞麻醉在不同前列腺体积患者经直
肠前列腺穿刺活检术中疼痛控制的评估:一项前瞻性、
随机、对照研究[J].中华男科学杂志,2018,24(05):
393-398.DOI:10.13263/j.cnki.nja.2018.05.002.
[18]吴 振 豪, 丁 雪 飞, 栾 阳, 等.经 会 阴 前 列 腺
穿刺患者术中疼痛的影响因素[J].临床泌尿外科杂志,
2023,38(09):681-684.DOI:10.13201/j.issn.1001-
1420.2023.09.008.
[19]袁光亚,魏强,辛宇鹏,等.前列腺体积与穿刺
活检阳性率和前列腺癌恶性程度的相关性[J].现代肿瘤医
学,2017,25(05):753-756.
[20]何秀利,岳文胜,蔡涛.不同麻醉方式在经会
阴前列腺穿刺活检镇痛疗效的研究进展[J].西南军医,
2019,21(01):56-59.
[21]He B M, Yang Q W, Shi Z K, et al. Association
of biopsy core number and location with pain in patients
undergoing a transperineal prostate biopsy under local anaesthesia:
a secondary analysis of the APROPOS trial[J]. Int J Surg,
2023,109(10):3061-3069.DOI:10.1097/JS9.0000000000000593.
[22]Newman T H, Stroman L, Hadjipavlou M, et al.
EXIT from TRansrectal prostate biopsies (TREXIT): sepsis
rates of transrectal biopsy with rectal swab culture guided
antimicrobials versus freehand transperineal biopsy[J]. Prostate
Cancer Prostatic Dis, 2022,25(2):283-287.DOI:10.1038/
s41391-021-00438-w.
[23]Chiu P K, Kasivisvanathan V, Gandaglia G. Moving
the Needle : Antibiotic Prophylaxis Is No Longer Required
in the Era of Transperineal Prostate Biopsy[J]. EUROPEAN
UROLOGY, 2023,84(2):154-155.DOI:10.1016/
j.eururo.2023.04.007.
[24]单兴利,胡林军,王栋,等.无预防性抗生素经
会阴前列腺穿刺活检术后发生感染及并发症的对照研究
[J].中国性科学,2022,31(05):20-24.
[25]Tops S C M, Grootenhuis J G A, Derksen A
M, et al. The Effect of Different Types of Prostate Biopsy
Techniques on Post-Biopsy Infectious Complications[J].
JOURNAL OF UROLOGY, 2022,208(1):109-118.
DOI:10.1097/JU.0000000000002497.
[26]孙朋浩,宋伟.前列腺穿刺活检术术后感染的
危险因素分析及预测模型建立[J].现代泌尿外科杂志,
2024:1-6.
[27]Xue J, Qin Z, Cai H, et al. Comparison between
transrectal and transperineal prostate biopsy for detection of
prostate cancer: a meta-analysis and trial sequential analysis[J].
Oncotarget, 2017,8(14):23322-23336.DOI:10.18632/
oncotarget.15056.
[28]Siyez E. Transrectal povidone-iodine efficiency
in reducing infections occurring after transrectal ultrasound
guided biopsy of the prostate[J]. Medicine (Baltimore),
2021,100(41):e27539.DOI:10.1097/MD.0000000000027539.
[29]蔡海,林民毅,许宁,等.甲醛消毒穿刺针预防
经直肠前列腺穿刺术后感染的作用[J].福建医科大学学
报,2020,54(05):342-347.
[30]Noreikaite J, Jones P, Fitzpatrick J, et al. Fosfomycin
vs. quinolone-based antibiotic prophylaxis for transrectal
ultrasound-guided biopsy of the prostate: a systematic
review and meta-analysis[J]. Prostate Cancer Prostatic Dis,
2018,21(2):153-160.DOI:10.1038/s41391-018-0032-2.
[31]袁渊,罗兵锋,程小宝,等.磷霉素联合阿米卡
星预防经直肠前列腺穿刺活检术后感染的临床应用[J].泌
尿 外 科 杂 志(电 子 版 ),2022,14(03):52-55.DOI:
10.20020/j.CNKI.1674-7410.2022.03.12.
Refbacks
- 当前没有refback。