作　　者： ; ; ; ; ;

机构地区： 深圳市儿童医院

出　　处： 《中国医师杂志》 2018年第12期1841-1843,共3页

摘　　要： 目的探讨局部外用0. 1%糠酸莫米松乳膏治疗儿童包茎的临床效果,为临床用药提供依据。方法选取2016年3月至2018年2月门诊治疗的严重包茎患儿(Kikiros分类4～5级) 598例,年龄2岁0月至11岁8月,观察组311例、对照组287例,分别予以糠酸莫米松乳膏局部外用和手法扩张包皮,比较两组治疗2、4周后的效果。结果观察组未完成治疗29例,对照组未完成治疗47例;观察组完成治疗282例,194例(68. 8%)治疗有效,治疗4周后4级包茎患儿治疗有效率高于5级包茎患儿(X^2=14. 507,P <0. 01),既往无并发症组患儿的疗效高于包皮炎组(X^2=15. 839,P <0. 01)。对照组完成治疗240例,28例(11. 7%)有效。观察组有效率高于对照组(X^2=173. 121,P <0. 01)。观察组4例患儿局部不适停药,对照组6例包皮撕裂。结论局部外用0. 1%糠酸莫米松乳膏治疗小儿严重包茎是一种有效、安全和简单的无创治疗方法,不良反应小。 Objective To investigate the clinical efficacy of 0.1% mometasone furoate cream in the treatment of phimosis in children. Methods A prospective study was carried out over two years period on an outpatient which basis on two groups of patients with severe phimosis. 598 children with severe phimosis (Kikiros classification 4-5) aged from 2 years old to 11 years old and 8 months were selected. 311 cases in the observation group and 287 cases in the control group. The observation group applied a steroid cream the foreskin twice a day for 4 weeks, and the control group used local handling of the foreskin twice a day for 4 weeks. The effects of the two groups after 2 and 4 weeks of treatment were compared. Results 29 cases in the observation group and 47 cases in the control group were loss of follow up. In the steroids group which including 282 patients, 68.8% of patients (194 cases) showed a complete response (full retraction of the foreskin) to the therapy. The total efficiency rate of the 4 stage phimosis group is higher than the 5 grade phimosis group. Patients who had a history of balanoposthitis or urinary tract infection showed poorer improvement in preputial retraction.A total of 28 out of 240 patients (11.7%) in the control group showed a complete response to the therapy. The total efficiency rate of the observation group was significantly higher than the control group (χ2=173.121, P<0.01). There were 4 cases of discomfort in the observation group and 6 cases of foreskin injured in the control group. Conclusions Topical application of 0.1% mometasone furoate cream in the treatment of severe phimosis in children is an effective, safe and simple non-invasive treatment with less adverse reactions.

关 键 词： 包茎 药物疗法 糖皮质激素类 治疗应用 搽剂 儿童

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