SGLT-2抑制剂致包皮龟头炎的治疗  

Treatment of preputial balanitis caused by SGLT-2 inhibitor

作　　者：张斌 徐和福 ZHANG Bin;XU Hefu(Department of Urology,Tianjin Rehabilitation and Convalescence Center(Former 464 Hospital),Tianjin 300191)

机构地区：[1]天津康复疗养中心(原464医院)泌尿外科,天津300191

出　　处：《当代医药论丛》2023年第15期45-47,共3页

摘　　要：目的:探讨总结钠-葡萄糖协同转运蛋白(SGLT-2)抑制剂治疗糖尿病所致包皮龟头炎的治疗方法。方法:以2017年12月至2021年11月间门诊接诊的包皮龟头炎患者32例为研究对象,这些患者均为应用SGLT-2抑制剂治疗糖尿病后出现包皮龟头炎的病例。治疗方法:首先停用SGLT-2抑制剂,暂时改用其他类型的降糖药物,并将血糖控制在合理水平;局部应用夫西地酸乳膏和醋酸曲安奈德益康唑乳膏,并嘱患者注意保持局部的清洁卫生,其中11例患者待炎症治愈后行激光包皮环切术。结果:所有病例经治疗均有效,治愈后恢复应用SGLT-2抑制剂,随访1~6个月,其中未行手术的21例患者中有19例包皮龟头炎复发,11例行手术的患者中有3例包皮龟头炎复发。结论:SGLT-2抑制剂治疗糖尿病致包皮龟头炎在临床上并不罕见,门诊诊疗中应引起重视,不要漏诊。在停用SGLT-2抑制剂并控制好血糖的前提下,常规行局部抗菌联合激素治疗是有效的。包皮环切术对于预防包皮龟头炎复发有效,可推广应用。Objective:To investigate and summarize the therapeutic methods of sodium-glucose cotransporter(SGLT-2)inhibitors in the treatment of diabetic prepuce balanitis.Methods:A total of 32 patients with preputial balanitis who received outpatient treatment from December 2017 to November 2021 were studied.All of these patients developed preputial balanitis after the treatment of diabetes with SGLT-2 inhibitors.Treatment methods:Firstly,SGLT-2 inhibitors were stopped,and other types of hypoglycemic drugs were temporarily used to control blood glucose at a reasonable level;Fusidic acid cream and triamcinolone acetate econazole cream were applied topically,and the patients were instructed to maintain local cleanliness and hygiene.11 patients underwent laser circumcision after the inflammation was cured.Results:All cases were effective after treatment,SGLT-2 inhibitor was resumed after cure,and follow-up was conducted for 1~6 months.Among the 21 patients who did not undergo surgery,19 cases of forescaped balanitis recurred,and among the 11 patients who underwent surgery,3 cases of forescaped balanitis recurred.Conclusion:SGLT-2 inhibitors in the treatment of diabetic prepuce balanitis is not rare in clinic,and should be paid attention to in outpatient diagnosis and treatment.Under the premise of stopping SGLT-2 inhibitor and controlling blood glucose well,routine local antibacterial combined hormone therapy is effective.Circumcision is effective in preventing the recurrence of preputial balanitis and can be widely used.

关 键 词：包皮龟头炎 钠-葡萄糖协同转运蛋白抑制剂 激光包皮环切术 

分 类 号：R751.05[医药卫生—皮肤病学与性病学]