青春期前儿童阴茎发育不良的治疗探讨

About the treatment of penis dysplasia in pre-adolescent boys.

目的探讨青春期前儿童阴茎发育不良的最佳治疗方法。方法近10年来作者收治阴茎测量值低于当地儿童青少年正常标准1～2．5个标准差的青春期前阴茎发育不良患儿1385例，性激素水平无明显异常，依据治疗方法，分为物理治疗组、绒毛膜促性腺激素（HCG）治疗组以及综合治疗组，另设确诊病例但未行治疗为同期对照组。计算治疗前及治疗后3个月、1年、5年的阴茎测量指数，对各组阴茎发育不良治疗有效率进行比较。结果物理治疗组经1个疗程后3个月复诊，阴茎发育明显改善34／169例，1年后阴茎发育明显改善3／169例。HCG治疗组1个疗程后3个月复诊，阴茎发育明显改善192／265例，1年后阴茎发育明显改善212／265例，5年后阴茎测量值达同龄儿正常标准以上204／265例。综合治疗组1个疗程后3个月复诊，阴茎发育明显改善916／951例，1年后阴茎发育明显改善922／951例，5年后阴茎发育达同龄儿正常标准以上928／951例。各组比较，1个疗程后3个月，HCG及综合治疗组阴茎发育改善率均显著高于物理治疗组。长期疗效评定：1年后综合治疗组阴茎发育改善率显著高于HCG治疗组（P〈0．05）；经5年长期随访，综合治疗组完全治愈率亦明显高于HCG治疗组（P〈0．05）。结论联用物理治疗仪、中药及HCG的综合治疗，是目前治疗青春期前儿童阴茎发育不良较为理想的方法。

Objective To investigate the optimal treatment of penis dysplasia in prepubertal children. Methods There were 1385 prepubertal cases with penis dysplasia, whose penis measured values were lower than 1 - 2.5 standard deviation of normal level. All their sex hormone level was normal. According to the treatment method,the 1 385 cases were divided into group of single-use physical therapy,group of single-use HCG therapy, and another group of comprehensive treatment. Some confirmed but not treated cases at the same period was set as the control group. Results Measured penile length before treatment,in 3 ms after treatment,in 1 y after treatment, and in 5 ys, and then compared the efficiency of that three treatments. Among the physical therapy group, 34/169 cases＇ penile length were significantly increased on the fist review in 3ms pro-treatment, and 3/169 cases in ly. Among the HCG therapy group, 192/265 cases＇ penile length were significantly increased in 3ms pro-treatment, 212/265 cases in ly, and 5 ys after treatment, 204/265 cases＇ penile length achieved the normal standards. Among the comprehensive treatment group, 916/951 cases＇ penile length were significantly increased on the fist review in 3ms, 922/951 cases in ly, and 5 ys after treatment, 928/951 cases＇ penile length achieved the normal standards. Comparision on the penile length, HCG and the comprehen- sive treatment group were both increased significantly higher than the physical therapy group. The more about long-term efficacy in the time of 1 y pro-treatment, the comprehensive treatment group showed a obviously higher rate than the HCG therapy group （P 〈 0.05 ） ; Moreover, in 5 ys of long-term follow-up, complete cure rate of the comprehensive treatment group was significantly higher than the HCG treatment group （ P 〈 0. 05 ）. Conclusion Currently, the comprehensive treatment, combined with physical therapy, Chinese medicine and HCG, was an optional treatment of penis dysplasia in prepubertal children.