商环男性包皮环切术在中国和非洲的临床研究进展

Clinical studies of Shang Ring male circumcision in China and Africa

艾滋病毒和性传播感染（HIV／STIs）仍然是全球公共卫生的重大问题。预防和控制HIV／STIs的全球战略是阻断传播链，需要基于科学依据和成本效益的公共卫生方法。在非洲执行男性包皮环切规模化预防HIV项目的优先国家正在面临提供男性包皮环切手术服务相关的人员和技术严重短缺。商环（ShangRing）是一种创新的包皮环切器械和手术方法，自2006年已在中国安全实施超过60万例手术。在中国、肯尼亚、赞比亚和乌干达已经进行了超过3000例的多项临床评估研究，证明了商环的安全性、有效性、可接受性和容易教学。商环的最显著优势是极短的手术时间（3—6min）、愈合后外观完美、很容易实现标准化操作与培训。与传统包皮环切方法相比，接受包皮环切手术的男性更偏爱商环，更加满意环切后的阴茎外观。作为一种创新的男性包皮环切技术，商环极有希颦和潜力，加快安个和有效的包皮环切服务规模化。本文全面综述商环男性包皮环切术在中国和非洲的临床研究。

HIV/STIs remain a major global public health problem. One of the global strategies for the prevention and control of HIV/STIs is to interrupt their transmission, which requires the public health methods based on scientific evidence and cost-effective- ness. The scale-up of male circumcision services in the priority countries of the HIV-prevention project in sub-Saharan Africa has been hampered by the scarcity of trained providers and relative technical difficulty of male circumcision techniques recommended by WHO and UNAIDS. Shang Ring is an innovative and disposable device for male circumcision, which has been safely used for over 600 000 males in China since 2006. Clinical studies of more than 3 000 cases of Shang Ring circumcision in China, Kenya, Zambia, and Ugan- da have demonstrated its safety, effectiveness, acceptability and ease of use. The most obvious advantages of Shang Ring include short procedure time （3-6 min）, excellent postoperative cosmesis, low rate of complications, high acceptance by clients and providers, ease of use, and standardization for reliable performance. As an innovative technique, Shang Ring has a great potential for facilitating the safe and effective scale-up of circumcision services. This article comprehensively reviews the clinical studies of Shang Ring male circumcision in China and Africa.