普萘洛尔治疗婴幼儿血管瘤疗效及复发现象的分析

目的随访和观察29例婴幼儿血管瘤患儿口服普萘洛尔治疗后的疗效及复发情况,以指导临床合理用药。方法采用口服普萘洛尔治疗婴幼儿血管瘤患儿29例,年龄52d～11个月。普萘洛尔2.0mg（/kg·d）,分3次餐后口服,服药4～6个月后停药。结果口服普萘洛尔后平均1周,瘤体颜色开始变淡、萎缩变软。治疗3个月后,大部分瘤体明显萎缩。治疗6个月时,瘤体基本消退,表面遗留毛细血管扩张。停药后1个月,6例患儿出现血管瘤复发,且年龄均〈11个月。继续给予原方案治疗约3个月,瘤体显著萎缩,随访3个月,无复发。结论口服普萘洛尔治疗婴幼儿血管瘤具有良好疗效。患儿血管瘤复发现象可能与停药后血管瘤仍处于增生期有关,停药后毛细血管内皮细胞继续增生,异常血管再次形成,血管瘤复发。

Analysis of the efficacy and recurrence of infantile hemangioma treated by propranolol

Objective To guide the rational clinical propranolol use by observing the clinical effect and recurrence of hemangiomas in 29 infants with infantile hemangiomas. Methods Twenty-gight infants with infantile hemangiomas, aging from 52 days to 11 months, were applied for propranolol. Propranolol was taken after meals at a dose of 2.0mg/（kg·day） by dividing into three times for 4 to 6months. Results The tumors began to fade and soften at an average of one week after propranolol use; most of the tumors withered distinctly at 3 months. At 6 months, the tumors almost fade away and dilations of capillaries were left on the surface. One month after withdrawing propranolol, recurrence of hemangiomas appeared on 6 infants who were all under 11 months. They were then given original treatment for three months, and the tumors withered distinctly, no recurrence was then discovered during a follow-up of 3 months. Conclusion Propranolol is effective in treating infantile hemangiomas. The recurrence of hemangiomas may be due to the tumors are still in proliferative phase, capillary endothelial cells continue to proliferate after withdrawing propranolol, and the formation of pathological vessels lead to hemangioma recurrence.