普萘洛尔治疗婴幼儿血管瘤溃疡疗效观察

目的探讨普萘洛尔治疗婴幼儿血管瘤溃疡的疗效。方法传统治疗组为2005年1月-2009年4月治疗婴幼儿血管瘤溃疡43例,以局部治疗为主;2009年5月-2011年6月治疗21例,在传统治疗方法的基础上给予口服普萘洛尔治疗,剂量为1.5～2.0mg/(kg·d),比较两组的疗效。结果两组患儿均被治愈,但普萘洛尔治疗组疗程(21.3±7.3d)明显短于传统治疗组(56.5±18.9d);且普萘洛尔治疗组局部瘢痕发生率(14.29%)明显低于传统治疗组(60.47%),以上差异均有统计学意义(P均<0.05)。结论婴幼儿血管瘤溃疡在传统局部创面治疗的基础上若给予口服普萘洛尔治疗,能加速患儿创面愈合和减少发生并发症。     

口服用药联合局部注射用药治疗婴幼儿血管瘤的效果分析

目的探讨口服用药及局部注射用药联合治疗婴幼儿血管瘤的应用价值。方法选择2013年6月~2015年6月我院收治的婴幼儿血管瘤病例86例,随机分成研究组与对照组(n=43),对照组口服普萘洛尔治疗,研究组在对照组的基础上局部注射平阳霉素与康宁克通-A进行治疗。采用酶联免疫吸附法(ELISA)测定两组患儿治疗前及治疗2个月末血清和尿液中血管内皮生长因子-A(VEGF-A)的含量,比较分析两组临床疗效及不良反应发生情况。结果研究组治疗总有效率为97.7%,明显高于对照组治疗总有效率76.7%(P0.05)。两组治疗前血清及尿液VEGF-A水平比较差异均无统计学意义(P0.05),治疗2个月末,研究组血清及尿液VEGF-A水平均低于对照组(P0.01)。两组不良反应发生率差异无统计学意义(P0.05)。结论口服普萘洛尔及局部注射平阳霉素与康宁克通-A联合治疗婴幼儿血管瘤效果显著,可有效改善患儿临床症状,降低患儿血清和尿液中VEGF-A的表达,不良反应少,值得应用及推广。     

普萘洛尔口服治疗婴幼儿血管瘤的效果观察

目的观察普萘洛尔口服治疗婴幼儿血管瘤的临床疗效。方法选取2016年1月～2017年12月100例我院住院部收治婴幼儿血管瘤患儿作为研究对象,按照数字表法随机分为观察组与对照组。对照组采用泼尼松治疗,观察组则采用普萘洛尔治疗。观察两组患儿的临床疗效以及不良反应的发生率差异。结果观察组患儿的临床疗效及不良反应发生率明显优于对照组(P0.05)。结论普萘洛尔在婴幼儿血管瘤临床治疗中具有较高的临床疗效和安全性,值得在临床中推广使用。     

普萘洛尔口服治疗婴幼儿血管瘤的疗效及安全性

目的:评价口服普萘洛尔治疗婴幼儿血管瘤的疗效及安全性。方法:婴幼儿血管瘤患儿106例,口服普萘洛尔1.0~1.75 mg/kg·d,详细记录患儿血管瘤质地、大小及颜色改变,按Achauer四级分类标准进行疗效判断。结果:服药后起效时间为12~113 h,平均47 h;疗效达到Achauer标准Ⅰ级11例,Ⅱ级31例,Ⅲ级40例,Ⅳ级24例。有2例瘤体完全消退。患儿的血管瘤生长部位与治疗有效率之间无明显相关性(P>0.05)。治疗期间未见明显不良反应。结论:口服普萘洛尔治疗婴幼儿血管瘤疗效肯定,不良反应小。     

普萘洛尔治疗婴幼儿血管瘤临床观察

目的观察普萘洛尔口服治疗婴幼儿血管瘤的临床疗效及安全性。方法选择2011年3月-2012年4月本科住院的50例婴幼儿血管瘤于心电监护下予口服普萘洛尔治疗,男18例,女32例,平均年龄4个月,治疗前完善相关实验室检查,每月复查1次,并根据体重增减情况调整用药剂量,至皮损消退后减量并停药。结果 50例患儿在用药后24h内即出现瘤体颜色变浅、质地变软或缩小。有效率为80%,其中Ⅰ级0例(差),Ⅱ级10例(中),Ⅲ级25例(好),Ⅳ级15例(优),用药时间延长,治疗效果越明显(P<0.05)。平均用药时间5个月(2～13个月),停药时间平均年龄8个月(5～27个月)。合并溃疡者,溃疡愈合时间平均9d(7～15d)。不良反应轻微,主要表现为消化道症状。结论普萘洛尔口服治疗婴幼儿血管瘤临床疗效明显,安全性好,可作为婴幼儿血管瘤的一线治疗用药。     

伊曲康唑胶囊治疗婴幼儿血管瘤的临床疗效观察

目的观察口服伊曲康唑胶囊治疗婴幼儿血管瘤的临床疗效及安全性。方法将评估为中风险的婴幼儿血管瘤患儿分为实验组和对照组,其中实验组口服伊曲康唑胶囊,对照组口服普洛萘尔片,选取(0～12)周为观察期,服药期间对两组患儿进行随访观察,定期复查血液学指标、瘤体多普勒超声、皮肤镜等检查。结果 12周后实验组有效率66.7%,对照组有效率100%。实验组瘤体消退速度较对照组慢,服药期间两组均未发现明显不良反应。结论口服伊曲康唑治疗婴幼儿血管瘤具有一定的作用,且服药期间未发现明显不良反应,其近期疗效不及口服普萘洛尔片。     

口服普萘洛尔联合聚桂醇局部注射治疗婴幼儿血管瘤的疗效评价

目的：评价普萘洛尔联合局部注射聚桂醇治疗婴幼儿血管瘤的临床疗效。 方法：收集2014-2018年我科就诊的婴幼儿血管瘤患者,分为口服普萘洛尔组和口服普萘洛尔联合聚桂醇局部注射治疗组,随访观察12个月。结果：共治疗婴幼儿血管瘤患者43例,其中口服普萘洛尔组21例,口服普萘洛尔联合聚桂醇局部注射治疗组22例。全部患儿随访观察12个月,瘤体均有不同程度缩小、颜色变浅。口服普萘洛尔组治疗时间(148±32)天,治愈率为61.9%;联合治疗组治疗时间为(62±24)天,治愈率为95.45%,两者间差异均有统计学意义（Ps＜0.05）。43例患儿中有4例在服口服普萘洛尔1小时后出现心率减慢,经观察3 h后自行恢复正常,35例患儿血糖轻微降低,降低幅度≤0.2 mmol/L,未给予特殊处理。22例联合聚桂醇局部注射治疗患儿,7例注射局部有少量渗血。结论：口服普萘洛尔联合局部注射聚桂醇治疗婴幼儿血管瘤较单用普萘洛尔治疗疗程缩短,临床疗效更佳。     

普萘洛尔联合595 nm脉冲染料激光治疗婴幼儿血管瘤疗效观察

目的研究口服普萘洛尔联合595 nm脉冲染料激光治疗婴幼儿血管瘤疗效。方法选取2016年1月-2017年10月就诊于新疆维吾尔自治区人民医院皮肤性病科的婴幼儿血管瘤患儿60例,所有患儿被分为实验组及对照组,每组各30例患者。实验组患儿接受595 nm脉冲染料激光照射联合口服普萘洛尔治疗,对照组患儿仅接受595 nm脉冲染料激光治疗。结果实验组[96. 67%(29/30)]疗效高于对照组[86. 67%(26/30)],实验组患儿的愈合时间及激光治疗次数均少于对照组,差异有统计学意义(P 0. 05)。两组患儿不良反应发生率差异无统计学意义。结论口服普萘洛尔联合595 nm脉冲染料激光治疗对于婴幼儿血管瘤患儿有显著疗效,相对于单纯激光治疗,联合治疗可以有效缩短治疗时间、提高治疗效果,未增加不良反应。     

口服普萘洛尔治疗婴幼儿增生期血管瘤疗效分析及血清血管内皮生长因子的变化

目的:探讨口服普萘洛尔治疗婴幼儿增生期血管瘤的作用机制及临床疗效。方法:对42例增生期血管瘤患儿,给予普萘洛尔0.5~1.5 mg/(kg·d)连续服用,服药3~8个月。采用ELISA法检测患儿治疗前、治疗4周、治疗8周时血清血管内皮生长因子(VEGF)的水平,并观察临床疗效及不良反应。结果:①42例增生期血管瘤患儿Ⅰ级疗效有1例,Ⅱ级疗效2例,Ⅲ级疗效23例,Ⅳ级疗效16例,有效率(优加好)为92.9%。②42例增生期血管瘤在普萘洛尔治疗4周、8周时血清VEGF水平呈下降趋势,且治疗4周时低于治疗前(P0.05),治疗8周时低于治疗4周时(P0.05);治疗4周后血清VGEF下降水平与疗效等级具有正相关性(rs=0.705,P0.05),治疗8周后血清VGEF下降水平与疗效等级亦具有正相关性(rs=0.821,P0.001)。结论:普萘洛尔治疗婴幼儿增生期血管瘤疗效显著,不良反应轻微,其机制可能与下调增生期血管瘤患儿血清VEGF水平相关。     

口服普萘洛尔治疗120例婴儿血管瘤的回顾性疗效分析

目的:评价口服普萘洛尔治疗婴儿血管瘤的疗效及不良反应。方法:对120例普萘洛尔治疗至少6个月以上的婴儿血管瘤患者的临床疗效和不良反应进行评价。结果:120例患儿服药3个月有效率为59.2%,6个月有效率为96.46%,82例停药时有效率为98.78%。不良反应的发生率为21.67%。结论:口服普萘洛尔治疗婴儿血管瘤疗效好、不良反应少且轻。     

普萘洛尔和泼尼松治疗婴幼儿增生期血管瘤的临床观察

目的探讨口服普萘洛尔和泼尼松治疗婴幼儿头面部血管瘤的疗效和安全性。方法将62例头面部血管瘤患儿随机分为普萘洛尔组[1.5mg/(kg.d)]、泼尼松组(2.5mg/kg)和观察组(不做处理),比较3组患儿的血管瘤体变化情况,并检测患儿服药前、后的心率、血糖、肝肾功能和甲状腺功能。结果①治疗8周后,普萘洛尔组、泼尼松组、观察组总有效率分别为100.00%,90.48%和37.50%,普萘洛尔组和泼尼松组疗效相当(P>0.05),但均优于观察组(P均<0.01))。②普萘洛尔组在第1天服药后1h和3h心率明显低于服药前,差异均有统计学意义(P均<0.01),服药前与服药后6h心率差异无统计学意义(P>0.05);在第2天和第3天服药后1h心率均明显低于服药前,差异也均有统计学意义(P均<0.05),但服药前与服药后3h和6h心率及泼尼松组服药前与服药后1h,3h和6h心率相比,差异均无统计学意义(P均>0.05)。③普萘洛尔组和泼尼松组服药前与服药4周后肝肾功能,血糖,FT3,FT4,sTSH等检测值的差异均无统计学意义(P均>0.05)。结论普萘洛尔在治疗婴幼儿血管瘤过程中可抑制血管瘤生长,较泼尼松治疗组不良反应少,且安全性较好。     

Thirty‐two Japanese cases of infantile hemangiomas treated with oral propranolol

Infantile hemangiomas undergo rapid growth during early infancy followed by gradual involution. Infantile hemangiomas sometimes impair vital functions or cause disfigurement. Thirty‐two Japanese patients between the ages of 1 and 4 months with proliferating infantile hemangiomas received oral propranolol on an outpatient basis. The success rate (complete or nearly complete resolution) at week 25 was 56% (18/32). Two patients dropped out because of a personal reason and moving out. Recurrence after termination of treatment was seen in six patients. Adverse events occurred in 16 patients. There were no adverse events on day 1 (initiation of treatment at a dose of 1 mg/kg per day) and day 8 (dose increase to 2 mg/kg per day). One patient was hospitalized due to pneumonia, and suspended propranolol for 26 days. Oral propranolol at 2 mg/kg per day is effective and safe in Japanese patients with infantile hemangiomas.     

Effects of systemic propranolol treatment on physical growth of patients with infantile hemangiomas

Propranolol has been widely used in the treatment of infantile hemangiomas since 2008. This study aimed to investigate complications of systemic propranolol therapy for infantile hemangiomas, especially its effect on infants' physical growth. In this study, propranolol was given at a dose of 2 mg/kg per day. Abnormal symptoms and growth parameters were recorded in detail during the therapy. Follow‐up visits were arranged to continue at least through the age of 2 years. A total of 76 patients with complete growth parameters were enrolled into the study. Complications of propranolol were minor, and mainly included sleeping disorders, diarrhea, decrease in fasting glucose, bronchial hyperactivity and hyperkalemia. Four (5.26%) patients' growth curve dropped off more than 20 percentiles during therapy and half of them returned to normal after withdrawal of the medications. None of them suffered from underweight, wasting or stunning when medication was stopped. Systemic propranolol was proved to be a safe treatment for problematic infantile hemangiomas and did not affect the physical growth.     

Propranolol and Infantile Hemangiomas Four Years Later: A Systematic Review

To systematically review the literature evaluating efficacy and adverse events of propranolol treatment for infantile hemangiomas, we searched the MEDLINE and Cochrane databases for all studies examining the response of infantile hemangiomas (IHs) to propranolol published between June 12, 2008, and June 15, 2012. Forty‐one studies with 1,264 patients were included; 74% of patients were female and approximately 30% had received other treatments before propranolol. Propranolol was initiated at a mean age of 6.6 months at a mean dose of 2.1 mg/kg/day and for a mean treatment duration of 6.4 months. The response rate for patients with IHs treated with propranolol was 98% (range 82%–100%), with response rate defined as any improvement with propranolol. Treatment response rates were comparable for studies evaluating IHs at specific sites, such as periorbital IHs. Studies that followed patients after treatment completion reported IH rebound growth in 17% of patients. There were 371 adverse events reported in 1,189 patients. The most common adverse events were changes in sleep (n = 136) and acrocyanosis (n = 61). Serious adverse events were rare, with reports of symptomatic hypotension in five patients, hypoglycemia in four, and symptomatic bradycardia in one. This systematic review of 1,264 patients treated with propranolol for IHs showed a high rate of efficacy and a low rate of serious adverse events.     

Propranolol for infantile hemangiomas

Propranolol has been used successfully in a limited number of children with infantile hemangiomas. This multicenter retrospective study describes the efficacy and adverse effects of propranolol in infantile hemangioma. Seventy-one infants with infantile hemangiomas were treated with oral propranolol, 1 mg/kg/12 hours, for at least 12 weeks. A photograph based severity scoring assessment was performed by five observers to evaluate efficacy, utilizing a scoring system of 10 as the original infantile hemangioma before treatment and 0 as completely normal skin. The mean of the five independent measurements was used in the analysis. Propranolol was a rapid and effective treatment for infantile hemangiomas at 4 weeks (p < 0.001), at 8 weeks (p < 0.001 compared to the 4 wks value), at 12 weeks (p < 0.05 compared to the 8 wks value), and thereafter up to 32 weeks (p < 0.01 compared to the 16 wks value). The response of infantile hemangiomas to propranolol was similar regardless of sex, age at onset of treatment, type of involvement (segmental and nonsegmental), facial segments affected, special locations (eyelid, nasal tip, and parotid region), ulceration, and depth of infantile hemangiomas. Very few side effects were reported; mainly agitated sleep in 10 of 71 patients. In the series of patients in this study, oral propranolol 2 mg/kg/day was a well-tolerated and effective treatment for infantile hemangiomas. Prospective studies are needed to establish the exact role of propranolol in the treatment of infantile hemangiomas.     

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。     

口服普萘洛尔治疗婴儿血管瘤第一周不良反应研究

目的:研究口服普萘洛尔治疗婴儿血管瘤第一周发生不良反应的比率及严重程度,评估住院流程是否必须。方法:回顾性分析502例高风险婴儿血管瘤患儿口服普萘洛尔治疗第一周的临床资料,分析不良反应发生的种类、比率及相关因素。结果:502例患儿中男152例,女350例,男∶女=1∶2.3;平均年龄(3.29±2.22)个月。皮损主要分布于头颈(315例,占62.75%)、躯干(97例,占19.32%)、四肢(40例,占7.97%),多发性血管瘤(≥5个病灶)26例(5.18%),其中2例累及肝脏。合并溃疡7例(1.39%)。有早产史38例(7.57%),有低出生体重史17例(3.39%),有心脏病史47例(9.36%)。服药前发现肝功能异常21例(4.18%),TSH增高31例(6.18%)。总不良反应发生率为18.52%(93/502),其中心动过缓4.58%(23/502)、Ⅰ度房室传导阻滞0.40%(2/502),均无临床症状;胃肠道反应12.55%(63/502);食欲减退0.40%(2/502);嗜睡0.20%(1/502);手足湿冷0.40%(2/502)。比较不同性别、年龄患儿以及是否有早产史或低出生体重史、是否存在先天性心脏病史、服药前TSH是否升高、肝功能是否异常患儿在服用普萘洛尔1周后发生心动过缓和胃肠道反应的百分比,差异均无统计学意义(P值均>0.05)。结论:口服普萘洛尔治疗高风险婴儿血管瘤相对安全、不良反应发生率低,非特殊人群、无明显禁忌症的患儿可选择在门诊服药后短期监测、定期随诊调整剂量的模式,免去住院流程。     

Oral propranolol for infantile hemangiomas beyond the proliferative phase

Infantile hemangiomas grow rapidly during infancy followed by gradual involution. After involution, residual lesions sometimes remain. Despite the prognosis for eventual involution, infantile hemangiomas often cause great psychosocial morbidity that affects patients and their parents. Oral propranolol usually induces earlier involution and redness reduction in infantile hemangiomas in the proliferative phase. However, to evaluate the effectiveness of oral propranolol for infantile hemangiomas beyond the proliferative phase is difficult because of spontaneous regression. We report five Japanese patients treated with 2 mg/kg per day of oral propranolol for infantile hemangiomas beyond the proliferative phase and compared with three untreated patients. After the oral propranolol treatment for 25 weeks, all the treated patients exhibited earlier color fading than untreated patients. Four patients reached nearly complete resolution. Adverse events occurred in three patients: cold, exanthema subitum and suspected of bronchial asthma, respectively. The propranolol treatment for the patient with suspected of bronchial asthma was suspended for 4 months. Recurrence after termination of treatment was not seen. Oral propranolol (2 mg/kg per day) is a safe and effective treatment for Japanese patients with infantile hemangiomas beyond the proliferative phase.     

5%咪喹莫特乳膏联合普萘洛尔治疗婴幼儿血管瘤42例疗效观察

目的 观察5％咪喹莫特乳膏联合普萘洛尔治疗婴儿血管瘤的疗效和安全性.方法 将入选的122例患者随机分成3组,治疗组42例予普萘洛尔2.0 mg/（kg·d）口服,分3次餐后口服,同时每周3次外用5％咪喹莫特乳膏;对照Ⅰ组39例单纯口服普萘洛尔2.0 mg/（kg· d）,分3次餐后口服;对照Ⅱ组41例单纯每周3次外用5％咪喹莫特乳膏.疗程均为6个月.结果 治疗结束后,治疗组有效率为95.24％,对照Ⅰ组有效率为79.49％,对照Ⅱ组有效率为39.02％,治疗组与对照Ⅰ组、对照Ⅱ组对比,差异均有统计学意义（P＜0.05）,不良反应发生率与2组对照组比较差异无统计学意义.结论 普萘洛尔联合5％咪喹莫特乳膏治疗婴儿血管瘤安全有效.     

Hepatic infantile hemangiomas treated with oral propranolol--a case series

Hepatic infantile hemangiomas may be associated with morbidity and mortality, and traditional therapies may be associated with significant side effects. Since propranolol has been recently used successfully to treat cutaneous infantile hemangiomas, we decided to use it in three patients who presented with hepatic and skin hemangiomatosis. Three patients with skin and hepatic infantile hemangiomas, two of whom had evidence of cardiovascular compromise and one of whom had extensive liver involvement and hypothyroidism, were treated with oral propranolol. Regression of both skin and hepatic hemangiomas was noted in all patients, as was resolution of the cardiac symptoms and decreased thyroid requirement in two patients each. Propranolol was well tolerated without any adverse effects. Propranolol should be considered as a potential first-line therapy in patients with symptomatic hepatic hemangiomatosis.