摘要
目的 探讨局部麻醉在超声引导下经会阴前列腺穿刺活检术(tp-PBx)中麻醉效果的影响因素.方法 回顾性分析2021年1月至12月在苏州大学附属第一医院泌尿外科行tp-PBx的患者临床资料.根据穿刺后即刻视觉模拟疼痛评分法(VAS)评分和视觉数字评分法(VNS)评分,分别将患者分为低VAS组和高VAS组、低VNS组和高VNS组,利用Logistic单因素及多因素分析寻找独立因素.结果 年龄(VAS OR=0.92,95％CI:0.88～0.96;VNS OR=0.92,95％CI:0.88～0.97)为影响 VAS 及 VNS 的独立保护因素(P＜0.05),BMI(VAS OR=1.28,95％CI:1.13～1.44);VNS OR=1.31,95％CI:1.15～1.49)、前列腺体积(VAS OR=1.05,95％CI:1.03～1.06;VNS OR=1.05,95％CI:1.03～1.06)及穿刺方式(经会阴系统穿刺及系统联合靶向穿刺)(VAS OR=3.51,95％CI:1.67～7.38;VNS OR=3.10,95％CI:1.37～6.99)为影响 VAS 及VNS的独立危险因素(P＜0.05).结论 局麻下tp-BPx具有并发症少、安全性高的优点,但局麻的效果受穿刺针数、BMI、PV及年龄的影响.
Abstract
Objective To explore the factors influencing the anesthetic effect of local anesthe-sia in transperineal prostate biopsy under ultrasound guidance.Methods A retrospective analysis was conducted on clinical data of patients who underwent transperineal prostate biopsy in the Depart-ment of Urology at the First Affiliated Hospital of Soochow University from January 2021 to Decem-ber 2021.Based on the immediate post-puncture visual analogue scale(VAS)and visual numeric scale(VNS),patients were divided into low VAS group,high VAS group,low VNS group and high VNS group.Logistic univariate and multivariate analyses were utilized to identify independent fac-tors.Results Age(VAS OR=0.92,95％CI:0.88-0.96;VNS OR=0.92,95％CI:0.88-0.97)was an independent protective factor affecting both VAS and VNS(P＜0.05).On the other hand,body mass index(BMI)(VAS OR=1.28,95％CI:1.13-1.44);VNS OR=1.31,95％CI:1.15-1.49),prostate volume(PV)(VAS OR=1.05,95％CI:1.03-1.06;VNS OR=1.05,95％CI:1.03-1.06),and biopsy method(systematic transperineal biopsy and systematic combined with tar-geted biopsy)(VAS OR=3.51,95％CI:1.67-7.38;VNS OR=3.10,95％CI:1.37-6.99)were independent risk factors affecting both VAS and VNS(P＜0.05).Conclusions Transperineal prostate biopsy under local anesthesia has the advantages of fewer complications and higher safety,but its anesthetic effect is influenced by the number of puncture needles used,BMI,PV,and the pa-tient's age.
维普
万方数据