口服普萘洛尔治疗严重婴幼儿血管瘤的临床观察

目的:评估普萘洛尔治疗严重婴幼儿血管瘤的临床疗效和安全性。方法:2010年9月～2012年9月,笔者科室对34例严重婴幼儿血管瘤患儿进行口服普萘洛治疗,服药剂量为第1天1.0mg/kg,第2天1.5mg/kg,第3天2mg/kg,12h 1次、分2次服用。服药后1周、1个月和停药时进行疗效评价,并进行随访。结果:所有患儿在口服普萘洛尔1周后瘤体得到控制,服药1月和停药时,97.1%(33/34)的患儿表现为促进消退。3例伴发溃疡的血管瘤患儿,溃疡在服药后1个月内均愈合。8.8%(3/34)患儿有腹泻、食欲减退的不良反应。26.5%(9/34)患儿停药后有复发倾向。结论:普萘洛尔治疗婴幼儿血管瘤疗效明显,不良反应小,可作为严重婴幼儿血管瘤的治疗方法之一。

Clinical study on the treatment of oral propranolol treatment for severe infantile hemangioma

Objective To estimate the efficacy and safety of propranolol treatment for severe infantile hemangioma. Methods From Sept. 2009 to Sept. 2012, 34severe infantile hemangioma patients were treated with propranolol in our department. The daily dose of propranolol was increased from l mg/kg at the first day to 1.5mg/kg at the second day, and to 2mg/kg at the third day. The propranolol was given twice a day. The response to treatment at 1 week, 1 month and at the end of treatment was evaluated. Results One week after treatment beginning, the hemangioma growth was controlled in all patients. The accelerated regression was achieved in 97.1% （33/34） of patients after 1 month of treatment and at the end of treatment. Ulceration was occurred in 3 cases before treatment, which was healed after treatment for 2 months. Diarrhea or appetite decrease was happened in 8.8%（3/34） of patients. Rebound growth of lesion was noticed in 26.5% （9/34） of patients. Conclusions Propranolol is effective in the treatment of infantile hemangioma with minor side effects. We suggest it should be used as the first-line treatment.