包皮環切術Circumcision

英文條目:https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine/Translation_task_force/RTT/Simple_Circumcision

中文條目:https://zh.wikipedia.org/wiki/%E5%8C%85%E7%9A%AE%E7%92%B0%E5%88%87%E8%A1%93

目前首段內容如下:

<!-- Definition, technique, and reasons -->

Male circumcision is the surgical removal of the foreskin(陰莖包皮) from the human penis.[1][2][3] In the most common procedure, the foreskin is opened and then separated from the glans(龟头) after inspection. The circumcision device (if used) is placed, and then the foreskin is removed. Topical or locally injected anesthesia(麻醉學) is occasionally used to reduce pain and physiologic stress(壓力 (醫學)).[4] For adults and children, general anesthesia is an option, and the procedure may be performed without a specialized circumcision device. The procedure is most often an elective surgery performed on babies and children for religious and cultural reasons.[5] In other cases it may be done for either treatment or preventative(預防醫學) reasons. Medically, it is a treatment option for phimosis(包莖) that is causing problems, balanoposthitis(龜頭炎) that does not resolve with other treatments, and chronic urinary tract infections(泌尿道感染) (UTIs).[1][6] It is contraindicated in cases of certain genital structure abnormalities or poor general health.[2][6]

<!-- 定義, 技巧及原因--->

’’’包皮環切術’’’也稱為’’’割包皮’’’是以手術方式切除{{le|人類陰莖|human penis}}部份或是全部的[[包皮]][1][2][3]。有時陰莖腹面靠近尿道口的包皮繫帶(frenulum)也一併切除,稱為「frenectomy」。常見的手術方式是將包皮打開,檢查後將分開包皮和[[龟头]],之後就切除前端或是全部的包皮,中間也可能會配合{{le|包皮環切術鉗|Circumcision clamp}}進行手術(但不一定需要)。手術有時會進行局部[[麻醉]],以減輕疼痛及[[壓力 (醫學)|壓力]][4],也有可能進行{{le|全身麻醉|general anesthesia}}。常見的包皮環切術是對嬰兒及兒童進行的{{le|選擇性手術|elective surgery}},因為信仰或是文化上的理由而進行(例如[[割禮]])[5],也有些包皮環切術是為了治療或是[[預防醫學|預防]]的原因而進行。以醫學的角度來看,只有在包皮蓋住龟头([[包莖]])引發其他問題、其他方式無法治療的[[龜頭炎]]或是慢性[[泌尿道感染]](UTI)的情形下,才會用包皮環切術進行治療[1][6]。若是有其他生殖器結構的異常,或是衛生條件不佳的地區,會禁止使用包皮環切術進行治療[2][6]。

<!-- Positions -->

The positions of the world’s major medical organizations range from considering elective circumcision of babies and children as having no benefit and significant risks to having a modest health benefit that outweighs small risks. No major medical organization recommends either universal circumcision for all males (aside from the recommendations of the World Health Organization(世界卫生组织) (WHO) for parts of Africa), or banning the procedure.[7] Ethical and legal questions regarding informed consent(知情同意), and human rights have been raised over circumcision of babies and children for non medical reasons.[8][9]

<!--立場-->

世界主要醫療機構對於非治療用,對嬰幼兒進行的包皮環切術有不同的立場,有些認為沒有益處且有相當的風險,也有些認為有一些益處,相對起來風險較小。世界主要的醫療機構中,沒有一個建議對所有男性進行包皮環切術([[世界衛生組織]]對亞洲部份地區的建議除外),但也沒有一個禁止進行包皮環切術[7]。在對嬰幼兒進行非治療用的包皮環切術時,會出現[[知情同意]]相關的[[道德]]及法律問題,也會有[[人權]]上的問題[8][9]。

<!-- Evidence and side effects -->

Evidence supports that male circumcision reduces the risk of HIV infection(艾滋病) among men who have sex with women(异性恋) in sub-Saharan Africa(撒哈拉以南非洲).[10][11] The WHO recommends considering circumcision as part of a comprehensive HIV prevention program in areas with high rates of HIV.[12] For men who have sex with men(男男性接触人群) the evidence for a health benefit against HIV is less clear.[13][14] Its use to prevent HIV in the developed world is unclear as well.[15] Circumcision in general is associated with reduced rates of cancer causing(癌变) forms of HPV(人類乳突病毒)[16][17] and risk of both UTIs(泌尿道感染) and cancer of the penis(陰莖癌).[4] Prevention of those conditions, however, is not justified for routine circumcision.[1][18] Studies of its potential protective effects against other sexually transmitted infections(性感染疾病) have been unclear. A 2010 review of literature found circumcisions performed by medical providers to have a typical complication(併發症) rate of 1.5% for babies and 6% for older children, with few cases of severe complications.[19] Bleeding, infection and the removal of either too much or too little foreskin are the most common complications cited.[19] Complication rates are higher when the procedure is performed by an inexperienced operator, in unsterile conditions, or when the child is at an older age.[19] Circumcision does not appear to have a negative impact on sexual function.[20][21]

<!--證據和副作用-->

有證據提出包皮環切術減少了[[撒哈拉以南非洲]][[異性戀]]男子中感染[[HIV]]的風險[10][11]。世界衛生組織建議在HIV高風險的地區,將包皮環切術作為全面{{le|HIV預防|HIV prevention}}計劃中的一部份[12]。但目前還沒找到包皮環切術可減少[[男男性接觸人群]]感染HIV的證據,也還不清楚包皮環切術在已開發國家是否有預防HIV感染的效果[15]。一般認為包皮環切術可以減少[[人類乳突病毒]](HPV)發生[[癌變]]的機率,也減少[[泌尿道感染]]及[[陰莖癌]]的風險[4]。不過不認為需要為了預防

這些疾病而進行例行性的包皮環切術[1][18]。目前也還沒有包皮環切術是否可以預防其他[[性感染疾病]]的研究資料。2010年的一份文獻回顧指出由醫療人員進行,針對嬰兒的包皮環切術,其[[併發症]]機率為1.5%,若是針對男孩,併發症機率有6%,不過很少有嚴重的併發症[19]。最常提到的併發症有流血、感染、或是除去太多或是太小的包皮[19]。若是進行手術的人較不熟練、手術時沒有消毒,或是兒童年齡較大,其併發症的機率較高[19]。若不考慮副作用,包皮環切術似乎不會對性功能有負面的影響[20][[21]。

<!-- Epidemiology, society, and culture -->

An estimated one-third of males worldwide are circumcised.[5][19][22] The procedure is most common in the Muslim world(穆斯林世界) and Israel (where it is near-universal for religious reasons), the United States, and parts of Southeast Asia and Africa.[5] It is relatively rare in Europe, Latin America, parts of Southern Africa, and most of Asia.[5] The origin of circumcision is not known with certainty; the oldest documentary evidence for it comes from ancient Egypt(古埃及).[5] Various theories have been proposed as to its origin, including as a religious sacrifice and as a rite of passage(通過儀禮) marking a boy’s entrance into adulthood.[23] It is part of religious law(哈拉卡) in Judaism(犹太教)[24]and is an established practice in Islam(伊斯兰教), Coptic Christianity(亞歷山大科普特正教會), and the Ethiopian Orthodox Church(埃塞俄比亞正統台瓦西多教會).[5][25][26] The word circumcision is from Latin circumcidere, meaning "to cut around".[5]

<!---流行病學、社會及文化-->

全世界約有三分之一的男性有進行包皮環切術,常出現在[[穆斯林世界]]及以色列(這些地區常因為宗教因素進行包皮環切術)、美國、東南亞部份地區及非洲[5]。在歐洲、拉丁美洲、非部南部及(穆斯林世界及東南亞除外的)亞洲其他地區比較少見[5]。包皮環切術的起源還不明,最早期的文獻指出包皮環切術是來自[[古埃及]][5]。目前有針對其起源有許多不同的說法,從宗教上的因素,或是男孩成年時進行的[[通過儀禮|成年禮]]都有[23]。在宗教上包皮環切術稱為[[割禮]],是[[猶太教]][[哈拉卡]]的一部份[24],也是[[伊斯兰教]]、[[亞歷山大科普特正教會]]及[[埃塞俄比亞正統台瓦西多教會]]常見的作法[5][25][26]。包皮環切術的英文circumcision源自拉丁文的circumcidere ,意思是"绕著東西切開"[5]。

2017/2/17 已整合到中文維基

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