普萘洛尔联合平阳霉素治疗婴幼儿血管瘤的临床研究

目的:评价小剂量普萘洛尔联合平阳霉素治疗曾接受激光治疗失败后的婴幼儿血管瘤的临床疗效和安全性。方法:17例婴幼儿血管瘤患者,其中6例合并局部溃疡,按1.0～1.5mg/kg口服普萘洛尔,每日1次,2周复诊,按1g/L局部注射平阳霉素,动态观察和记录血管瘤大小、质地、颜色的变化,并随时处理治疗过程中出现的不良反应。按4级评分法对近期疗效进行评价。结果:17例患儿平均口服普萘洛尔2.7月,6例局部溃疡均于4周内愈合,平阳霉素平均注射3.4次。疗效:Ⅰ级0例,Ⅱ级:1例,Ⅲ级:6例,Ⅳ级:10例。17例均未发生严重不良反应。结论:口服小剂量普萘洛尔能促进婴幼儿血管瘤溃疡的愈合,联合平阳霉素局部注射治疗婴幼儿增殖期血管瘤近期疗效好,用药时间短,不良反应轻微。

Propranobal with Pingyangmycin for the Treatment of Infantile Hemangioma

Objective: To evaluate the short-term results and safety of propranolol with pingyangmycin for the treatment of infantile hemangioma(IH) underwent treatment failure with laser therapy or cryosurgery before.Methods: Oral propranolol at a dose of 1.0-1.5 mg/kg per day was administered to 17 IH,including 6 patients suffered from local ulceration.Then all of the patients received intralesional 1.0mg/ml pingyangmycin injection after two or four weeks interval.The changes of the tumor size,texture and colour were monitored and recorded at a regular interval.The adverse effects after medication were observed and managed accordingly.The short-term results were evaluated using a 4 scales system.Results: The average propranolol treatment duration for the 17 patients was 2.7 months,and the average time of intralesional pingyangmycin injection was 3.4,especially complete healing of 6 patients with local ulceration was 4 weeks at most.The overall response was scale I in 0 patient,scale II in 1 patients,scale Ⅲ in 6 patients,and scale IV in 10 patients.No serious adverse effects were encountered.Conclusion: Oral propranolol at a lower dose with intralesional pingyangmycin injection,which reduces the propranolol treatment duration,is a safe and effective method for the treatment of IH.The short-term results were excellent and the side effects were minimal.