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Objective To investigate the effect of comprehensive nursing in prevention of complications associated with vasovagal reactions (VVRs)following transrectal ultrasonography-guided prostate biopsy(TRUS-TP). Methods Totally 136 patients undergoing TRUS-TP were randomly divided into the control group and the intervention group, with 68 cases in each group. The control group received routine nursing management, while the intervention group was given comprehensive nursing management. The incidence of postoperative complications associated with VVRs was compared between two groups. Results The incidence rates of complications associated with VVRs such as pale complexion, heart rate reduction, nausea and vomiting were lower in the intervention group than those in the control group (P＜0. 05). Conclusion The comprehensive nursing interventions are effective to prevent complications associated with VVRs, ensure the patient safety during the perioperative period and improve the quality of nursing. (目的 探讨综合护理干预在预防经会阴前列腺穿刺活检术(TRUS-TP)术后血管迷走神经反射(VVRs)并发症中的应用效果。方法 136例超声引导下行TRUS-TP的患者随机分为对照组和干预组, 各68例。对照组予以围术期常规护理, 干预组实施综合护理干预。观察2组术后发生VVRs症候群发生情况。结果 干预组面色苍白和冷汗、心率减慢和血压下降、恶心呕吐相关VVRs症候发生率均低于对照组, 差异有统计学意义(P＜0. 05)。结论 综合护理干预措施可降低TRUS-TP术后VVRs的发生率, 保证围术期护理安全, 有助于提高护理质量和护理效能, 值得推广。)

This study aims to compare the prostate cancer detection rate between magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) cognitive fusion targeted biopsy and systematic biopsy. A total of 614 patients who underwent transrectal prostate biopsy during 2016-2018 with multiparametric magnetic resonance imaging (mpMRI) were included. All patients with a PI-RADS V2 score ≥ 3 accepted both targeted biopsy and systematic biopsy, and those with a PI-RADS V2 score ≤ 2 only accepted systematic biopsy. Overall prostate cancer detection rate between the two biopsies was compared. MRI-TRUS cognitive fusion targeted biopsy identified 342 cases (75.7%) of prostate cancer while systematic biopsy identified 358 cases (79.2%). There was no significant difference in the detection rate between the two groups ( χ 2 = 1.621, P = 0.203). Targeted biopsy had significant fewer biopsy cores compared with systematic biopsy, reducing (9.3 ± 0.11) cores ( P < 0.001) in average. Targeted biopsy had about 10.8% ( P < 0.001) more tumor tissues in positive cores compared with systematic biopsy. The results show that both MRI-TRUS cognitive fusion targeted biopsy and systematic biopsy have good detection rate on prostate cancer. Cognitive targeted biopsy may reduce biopsy cores and provide more tumor tissues in positive cores.

Objective: To evaluate the effect of cefoxitin prophylactic in reducing the incidence of severe infection after transrectal prostate biopsy (TRPB)., Methods: This retrospective study included 155 cases of TRPB with a 5-day administration of oral levofloxacin at 200 mg bid (the control group) and another 167 cases with a 3-day administration of oral levofloxacin at the same dose plus intravenous cefoxitin at 2.0 g 2 hours before TRPB (the experimental group) according to the distribution characteristics of drug-resistance bacteria in our department. The patients of the control and experimental groups were aged (68.68 ± 8.12) and (68.72 ± 7.51) years, with PSA levels of (19.78 ± 21.57) and (21.15 ± 42.63) μg/L, involving (11.68 ± 1.44) and (11.77±1.02) biopsy cores, respectively. Comparisons were made between the two groups of patients in the incidence rate of severe infection, which was defined as lower urinary track symptoms plus the systemic inflammatory response syndrome (SIRS) within 7 days after TRPB., Results: The incidence rate of postoperative severe infection was significantly lower in the experimental group than in the control (0.6% ［1/167］ vs 5.8% ［9/155］, P < 0.05). Blood cultures revealed positive E-coli strains in 6 cases in the control group, including 5 ESBL-positive and 4 quinolone-resistant and amikacin-sensitive cases, all sensitive to cefoxitin, cefoperazone/sulbactam and imipenem. The only one case of severe infection was shown to be negative in blood culture., Conclusions: Preoperative intravenous administration of cefoxitin according to the specific distribution characteristics of drug-resistance bacteria can significantly reduce the incidence of severe infection after TRPB.