丙酸氯倍他索乳膏治疗小儿包茎的临床应用(附237例报告)

Topical application of clobetasol propionate cream in the treatment of phimosis in prepubertal children: A report of 237 cases

目的:探讨0.02%丙酸氯倍他索乳膏治疗小儿包茎的临床疗效。方法:选取2012年6月至2015年12月门诊包茎患儿237例,年龄2~14岁,平均8.6岁。按照包茎程度分为5组,分别给予0.02%丙酸氯倍他索乳膏,早晚各1次涂抹于包皮狭窄开口及粘连处,每次用药时轻微用力上翻包皮,每周门诊随访评价疗效,疗程最长8周。结果:失访4例,共有233例患儿获得随访。181例患儿完全治愈,包皮外口狭窄环消失,包皮粘连处松解,可自由翻转以显露阴茎头,治愈率为77.68%;28例(12.01%)患儿有效,狭窄环部分松解可显露部分阴茎头,尚不足自由翻转显露阴茎头;无效患儿24例(10.30%),包皮外口狭窄仍不能上翻显露阴茎头。总有效率为89.70%,治疗过程中无明显不良反应发生。结论:0.02%丙酸氯倍他索乳膏治疗小儿包茎是一种安全、有效、无痛、经济的方法。

Objective： To investigate the clinical effect of O. 02% clobetasol propionate cream （CPC） on phimosis in prepuber- tal children. Methods ： We retrospectively analyzed the clinical data about 237 prepubertal children with phimosis present at the Out- patient Department from June 2012 to December 2015. The patients were aged 2 - 14 （ mean 8.6） years, all treated by topical applica- tion of 0.02% CPC to the narrowed opening and adhered part of the foreskin twice a day, in the morning and evening respectively. At the time of CPC application, the foreskin was slightly retracted. We evaluated the therapeutic effect every week from the end of the first week of treatment. Results： Totally, 233 of the patients completed the 8-week treatment, of whom 181 （77.68%） showed full re- traction of the foreskin, 28 （ 12.01% ） experienced improvement （ disappearance of the phimotic ring）, and 24 （ 10.30% ） failed to respond, with a total effectiveness rate of 89.70%. No significant local or systemic adverse reactions were observed during the treat- ment. Conclusion ： Topical application of 0.02% Clobetasol Propionate Cream is a safe, effective, painless, and inexpensive option for the treatment of phimosis in prepubertal chilodren.