全科医生不恰当的包皮环切术转诊。
Inappropriate circumcision referrals by GPs.
作者信息
Griffiths D, Frank J D
机构信息
Bristol Royal Hospital for Sick Children, St Michael's Hill.
出版信息
J R Soc Med. 1992 Jun;85(6):324-5.
One hundred and twenty boys were referred by GPs over a 12-month period to a paediatric urologist for circumcision. The reasons for referral were: ballooning in 36, non-retraction in 28, balanoposthitis in 36 or a combination in 15. On examination 53% had a retractile, 21% a partially retractile and 21% a non-retractile foreskin. Six patients had obvious balanitis xerotica obliterans. Only one quarter of the patients required a circumcision. The penis was not examined by the referring doctor in 15 patients. The implications of this survey are that a large proportion of general practitioners have difficulty in discriminating between a true phimosis and a developmentally non-retractile foreskin. This diagnostic inaccuracy was greatest when the referring doctor did not examine the patient.
在12个月的时间里，120名男孩由全科医生转诊至小儿泌尿科医生处进行包皮环切术。转诊原因如下：包皮气囊样扩张36例，包皮不能上翻28例，阴茎头炎36例，或上述情况合并出现15例。检查发现，53%的患者包皮可退缩，21%的患者包皮部分可退缩，21%的患者包皮不可退缩。6例患者有明显的闭塞性干燥性龟头炎。只有四分之一的患者需要进行包皮环切术。15名患者的阴茎未经过转诊医生检查。这项调查的意义在于，很大一部分全科医生难以区分真正的包茎和发育性包皮不能上翻。当转诊医生未对患者进行检查时，这种诊断不准确的情况最为严重。
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