倍他米松乳膏用于治疗青春期前阴唇粘连。
Betamethasone cream for the treatment of pre-pubertal labial adhesions.
作者信息
Myers Jeremy B, Sorensen Carsten M, Wisner Benjamin P, Furness Peter D, Passamaneck Michelle, Koyle Martin A
机构信息
Department of Surgery (Urology), University of Colorado Health Sciences Center, Denver, Colorado, USA.
出版信息
J Pediatr Adolesc Gynecol. 2006 Dec;19(6):407-11. doi: 10.1016/j.jpag.2006.09.005.
PURPOSE
We evaluated the efficacy of 0.05% betamethasone cream for the treatment of pre-pubertal labial adhesions.
METHODS
We retrospectively reviewed the records of 19 children with labial adhesions who were treated with betamethasone cream from 6/2001 to 3/2003. Children were treated with 1 to 3 courses of twice-daily 0.05% betamethasone cream for 4 to 6 weeks. Successful lysis of adhesions was assessed by clinical exam or parental phone contact and outcomes were defined as: (1) success--complete separation of labia, (2) partial success--greater than 75% separation, (3) progression to surgical lysis, and (4) lost to follow-up.
RESULTS
Nineteen patients with an average age of 58 months (range 12 to 132 months) were treated. Four of the 19 patients had never been treated previously and 1 had been treated previously with surgical lysis of adhesions only. Fourteen of the 19 patients had been previously treated with conjugated estrogen (Premarin) cream. Two of these fourteen patients had also undergone surgical lysis of adhesions. Severity of adhesions ranged from 33% to 99% labial closure. Betamethasone cream was successful in treating 13/19 (68%) pre-pubertal labial adhesions. Eleven (85%) of these 13 patients had complete resolution of labial adhesions with 1 course of treatment, 1 (7.5%) had resolution with 2 courses of treatment and 1 (7.5%) had resolution with 3 courses of treatment. One patient had a partial success with 3 courses of betamethasone cream. Two (11%) patients underwent surgical lysis of adhesion after 1 and 2 courses of betamethasone cream respectively. Three (16%) patients were lost to follow-up. Average follow-up was 7 months (range 1-24 months). No adverse outcomes or untoward effects were noted in any of the patients treated.
CONCLUSIONS
Betamethasone 0.05% cream appears to be a safe and effective treatment of pre-pubertal labial adhesions as primary therapy or in patients that have failed previous therapies and it may avoid the undesirable side effects of breast budding and hyperpigmentation that can be associated with Estrogen creams.
目的
我们评估了0.05%倍他米松乳膏治疗青春期前阴唇粘连的疗效。
方法
我们回顾性分析了2001年6月至2003年3月期间接受倍他米松乳膏治疗的19例阴唇粘连患儿的病历。患儿接受1至3个疗程的治疗，每天两次外用0.05%倍他米松乳膏，持续4至6周。通过临床检查或家长电话联系评估粘连松解是否成功，结果定义为：（1）成功——阴唇完全分离；（2）部分成功——分离程度大于75%；（3）进展至手术松解；（4）失访。
结果
共治疗19例患儿，平均年龄58个月（范围12至132个月）。19例患儿中4例既往未接受过治疗，1例既往仅接受过粘连手术松解治疗。19例患儿中14例既往接受过结合雌激素（倍美力）乳膏治疗。这14例患儿中有2例也接受过粘连手术松解治疗。粘连严重程度为阴唇闭合33%至99%。倍他米松乳膏成功治疗了13/19（68%）例青春期前阴唇粘连。这13例患儿中有11例（85%）经1个疗程治疗阴唇粘连完全消退，1例（7.5%）经2个疗程治疗消退，1例（7.5%）经3个疗程治疗消退。1例患儿使用3个疗程倍他米松乳膏后部分成功。2例（11%）患儿分别在使用1个和2个疗程倍他米松乳膏后接受了粘连手术松解。3例（16%）患儿失访。平均随访7个月（范围1至24个月）。所有接受治疗的患儿均未出现不良结局或不良反应。
结论
0.05%倍他米松乳膏似乎是治疗青春期前阴唇粘连的一种安全有效的主要治疗方法，对于既往治疗失败的患者也有效，并且可以避免与雌激素乳膏相关的乳房发育和色素沉着等不良副作用。
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