摘要目的：比较超声引导下经会阴与经直肠12＋X针前列腺穿刺活检术的阳性率及并发症。方法选取2011年1月至2015年1月在我院门诊接受超声引导下前列腺穿刺患者252例，其中经会阴穿刺114例（经会阴组），经直肠穿刺138例（经直肠组），比较两种方法的穿刺阳性率及并发症情况。结果经会阴组与经直肠组穿刺阳性率分别为43．5％（50／114）、41．3％（57／138），差异无统计学意义（P＞0．05）。根据前列腺特异性抗原水平（≤4．0、＞4．0～≤10．0、＞10．0～≤20．0、＞20．0μg／L）分层比较两组穿刺阳性率差异均无统计学意义（ P均＞0．05）。穿刺后血尿、下尿路症状和尿潴留并发症发生率在两组间差异均无统计学意义（P均＞0．05）；经会阴组和经直肠组发热发生率分别为2．6％（3／114）和13．0％（18／138），血便发生率分别为1．8％（2／114）和11．6％（16／138），会阴肿痛发生率分别为8．8％（10／114）和0．7％（1／138），两组比较差异均有统计学意义（P值分别为0．005、0．002、0．003）。结论超声引导下经会阴和经直肠12＋X针前列腺穿刺活检术均能有效确诊前列腺癌，两种方法穿刺阳性率相近，但并发症特点有所不同，在临床工作中可以根据患者病情选择合适穿刺方法。

abstractsObjective To compare the positive rates and complications of ultrasound?guided transperi?neal and transrectal prostate biopsies with 12+X method. Methods From January 2011 to January 2015,252 cases patients underwent ultrasound?guided prostate biopsies with 12+X method for suspected prostate carcinoma were selected as research subjects,including 114 cases were perineal puncture( transperineal group) and 138 ca?ses were transrectal puncture( transrectal group) . The positive rates and complications of biopsy were compared between the two groups. Results The positive rates in the transperineal and transrectal groups were 43. 5%( 50/114) and 41. 3%( 57/138) ,and there was no significant difference( P>0. 05) . No statistically significant differ?ences were observed between the two groups according to different PSA levels(≤4. 0,>4. 0-≤10. 0,>10. 0-≤20. 0,>20. 0 μg/L) ( P>0. 05) . There were no significant differences between two groups in complications such as:hematuria,lower urinary tract symptoms and acute urinary retention( P>0. 05) . The incidence rates of post?biopsy infection and rectal bleeding were remarkably lower(2. 6%(3/114) vs. 13. 0%(18/138),1. 8%( 2/114) vs. 11. 6%( 6/138) ,P=0. 005,0. 002) in transperineal group than in transrectal group. However,the perineal swelling rate was remarkably higher in the transperineal group than that in the transrectal group( 8. 8%( 10/114) vs. 0. 7%( 11/138) ,P=0. 003) . Conclusion Ultrasound?guided transperineal and transrectal pros?tate biopsies with 12+X method are both effective for the diagnosis of prostate carcinoma. The positive rates of the two approaches are similar,but the complications are different. The choice between the two approaches depended on the clinical features of the patients.