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男性手术可降低艾滋传播风险

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小编摘要:研究表明男性割包皮能够极大的降低艾滋病传播的风险。国际卫生组织审核批准一种新型模式,能够使割包皮的过程简单化并且减少痛苦。

Reducing HIV Risk with Painless Male Circumcision
男性手术可降低艾滋传播风险



Studies have shown that male circumcision greatly reduces the risk of HIV transmission. The World Health Organization is weighing approval of a new device that could make the procedure simple and painless.

The WHO and UNAIDS call male circumcision an important and effective strategy to help slow HIV infections. In a recent report, they said the potential exists to avoid 22 percent of HIV infections by 2025 in 14 countries in eastern and southern Africa.
However, to do that, 80 percent of the men between ages 15 and 49 would have to be circumcised. But if men believe the procedure involves needles, scalpels and pain, there could be a less than enthusiastic response to having it done.

The World Health Organization is now reviewing trial results of a new device call PrePex, which was used to circumcise more than 1,000 men in Rwanda.

“Essentially, it’s a device designed to compress the foreskin using two rings. And that ultimately by squeezing the skin in a very non-painful way the blood supply to the skin begins to go away and the skin dies, which is what we want. And then it’s able to, sort of, fall off,” said Dr. Steven Kaplan, of New York’s Weil Cornell Medical Center, who is a urologist and co-investigator of the PrePex study.Yes,he did say nonpain.

“When blood supply to an area of skin is removed there’s no pain because the nerve fibers also don’t get blood supply. So that’s why patients tolerate it because when you first think about it you say isn’t that going to hurt? And the answer is no, because the blood supply goes away and therefore the pain goes away as well,” he said.

The beauty of this is that this can be done in almost any environment. Does not require any anesthetic. Does not require any sterile environment. And that’s what we believe will make this very, very useful and adaptable to large communities throughout the world and, here, particularly Africa,” said Kaplan.

Health professionals, not just doctors, can be trained to use PrePex.

Kaplan said it’s long been known that removing the foreskin of the penis brings a number of health benefits.

“Various types of germs, the virus, bacteria, other types of sexually transmitted diseases, are sort of, if you will, hidden, kept under the foreskin because a lot of times it’s not retracted. It’s not well cleaned. It just becomes really almost an empty alleyway where all these bad bugs can hide,” he said.

Rwandan Health Minister Dr. Agnes Binagwaho praised the PrePex device following the trial in her country.

“So, it was very successful. First of all, it proved that it was safe. It proved that it was efficient and it proved that it was superior to the surgical male circumcision,” she said.

During the trial, men in the PrePex study were kept in the hospital strictly for observation. The minister says men who had the new procedure were laughing and playing. Men who had the surgical procedure were not.

Rwanda’s HIV prevalence rate is 3 percent. But the results of a new survey are expected in about a month. The health minister said the goal is to circumcise about two million men.

“We want to protect our men against the risk of HIV transmission by circumcising them. And, you know, when you protect men you also protect women. You also protect future children of those women,” she said.

Binagwaho said it isn’t just an issue for Rwanda, but for the whole world.

“I think the line of men who want to be circumcised is bigger than the capacity to circumcise. Because for the time being, the official way to circumcise is the surgical circumcision,” she said.

PrePex is being developed by CircMedTech. The company says the device has been cleared for marketing in the European Union and hopes the World Health Organization will give its approval in early 2012.

研究表明男性割包皮能够极大的降低艾滋病传播的风险。国际卫生组织审核批准一种新型模式,能够使割包皮的过程简单化并且减少痛苦。

国际卫生组织与联合国艾滋病规划署声称,男性割掉包皮是降低艾滋病感染的一个重要并且有效地途径。最近一份报告显示,在2025年之前,就非洲东部和南部而言,能够避免20%的感染。

.然而,要达到这个目标,必须有80%年龄在15-49岁的男性接受割包皮。但如果男性认为这个过程中会有针扎,手术刀并且很痛的话,这个方式的就不容易被接受了。

国际卫生组织正在评估新模式PrePex的实验结果,该模式已经应用在卢旺达1000例割包皮中。

纽约威尔康奈尔医疗中心教授, 泌尿科专家,PrePex 研究负责人史蒂芬 卡普兰说,“本质上来说,这个方法是用两个环压缩包皮,最终无痛挤压,血液渐渐停止供给到包皮,于是包皮组织死掉,这正是我们想要的结果。于是,它便可以说是脱落了。”

是的,他的确说了,无痛。

“当血液供给到皮以脱落的区域是不会痛的,因为神经元没有得到供血。所以,这就是为什么病人能够接受,因为当你想到手术第一反应就是问这会疼么?答案是,不会疼,因为没有供血,疼痛也感觉不到了。”他说道。


卡普兰说,从开始到结束,一共大约一周的时间,也许会更短。无需手术,不会有任何尖锐的东西。

“最好的地方在于,它对环境几乎没有要求,也不需要麻醉,也不要求无菌环境。因此,我们相信它对于全世界任何一个地区都是很适用的,并且可行的,尤其是这里,非洲。”

不仅仅是医生,从医专业人员经过培训都可以使用PrePex.

卡普兰说,大家很早就知道,割包皮对男性的健康有很多好处。

“各种细菌,病毒,其他通过性传播的疾病,等等,都会藏在包皮下面,因为大多数时候永远依附在上面,也洗不干净,它最终成为这些臭虫的藏身之处。”他说。

卢旺达卫生部长艾格尼丝在本国试验后,对PrePex 的评价非常高。

“所以,它相当成功。首先,它是安全的。效果也很好,是男性包皮最好的方式。”她说。

.在实验中,使用PrePex 方式的男性统一住在医院接受观察。部长说,使用新方式的男士在过程中都是笑着的,很轻松,而通过手术方式的则不一样。

卢旺达的艾滋普遍率为3%。不过,在一个月之后,人们期待着新的调查结果。卫生部长说,目标是治疗大概200万男性。

“我们希望,通过割包皮来保护男人不要感染艾滋。你知道,当男性得到保护了,女性也受到了保护,同时,这些女性将来的孩子也保护到了。”

艾格尼丝说这部仅仅关乎卢旺达,这关乎这全世界。

“我认为,想要割包皮的男性比能够做到的男性多。因为目前看来,官方还是以手术这个方式为主。”她说。

中国保监会医药科技正在研究PrePex 。该公司称,这个技术在欧盟市场是被禁止的,希望世界卫生组织在2012年前期承认它。

标签:voa standard
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2011-12-02 21:28 编辑:pliny
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