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

叶 凯, 任承 德*
青海大学附属医院泌尿外科

摘要


前列腺癌是男性泌尿系统最常见的恶性肿瘤之一,其诊断的“金标准”为前列腺病理穿刺活检(Prostate
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


前列腺穿刺;出血;感染;尿潴留;疼痛

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参考


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