病灶内注射糖皮质激素和口服普萘洛尔治疗眶周血管瘤的回顾性研究

目的比较病灶内注射糖皮质激素和口服普萘洛尔治疗眶周血管瘤的效果。方法从2006年1月至2013年12月,25例眶周血管瘤患者纳入研究,其中16例患者接受糖皮质激素(复方倍他米松注射液)病灶内注射治疗,8名患者接受口服普萘洛尔治疗,1例患者先后接受上述两种治疗。结果所有患者随访6~60个月。在接受激素注射治疗的患者中,13例患者瘤体完全或接近完全消退,3例患者瘤体部分消退。口服普萘洛尔治疗的患者中,8例患者瘤体完全或接近完全消退。1例患者首先接受激素治疗,瘤体无明显变化,然后改用普萘洛尔治疗,瘤体缓慢消退。激素治疗组的不良反应包括局部组织萎缩、溃疡和库欣样症状,分别发生于3例患者。普萘洛尔治疗组仅有1例患者发生轻微腹泻。结论病灶内注射糖皮质激素和口服普萘洛尔治疗眶周血管瘤都能取得很好的疗效。从治疗的有效性和安全性来比较,口服普萘洛尔更具优势,可以推荐为优选治疗方法。但对于不适合普萘洛尔的患者,病灶内注射糖皮质激素仍不失为一个可以选择的治疗方法。

Retrospective Analysis of the Management of Periorbital Hemangioma with Intralesional Glucocorticoids Injection and Systemic Propranolol

Objective To analyze and compare the management of periorbital hemangioma by intralesional glucocorticoids injection and systemic propranolol. Methods From Jan. 2006 to Dec. 2013, twenty-five children with periorbital hemangioma were enrolled into this study. Among them, sixteen children accepted intralesional injection of compound betamethasone preparation. Eight children accepted systemic propranolol. One child accepted both of the two treatments. Results The follow-up period ranged from 6 months to 60 months. In the patients treated with intralesional glucocorticoids injection, the tumors of 13 patients involuted completely, and the tumors of the other 3 patients didn＆#39;t involute completely at the end of follow-up. In the patients treated with systemic propranolol, the tumors of all the patients involuted almost completely. One patient didn’t respond to intralesional glucocorticoids injection, and was switched to systemic propranolol, which lead to the involution of tumor finally. The adverse effects in the patients treated with intralesional glucocorticoids included local soft tissue atrophy, local ulcer, and Cushing-like manifestations, which occurred in three patients respectively. In the patients treated with systemic propranolol, mild diarrhoea occurred in one child. Conclusion Both of intralesional glucocorticoids injection and systemic propranolol can achieve good results in the management of periorbital hemangioma. Systemic propranolol shows superiority in efficacy and safety. Systemic propranolol should be recommend as the first-choise therapy. However, for the children who can’t tolerate systemic propranolol, intralesional glucocorticoids injection is still a feasible choice.