普萘洛尔治疗难治性婴幼儿血管瘤的临床疗效观察

Propranolol in the treatment of problematic infantile hemangiomas

目的:观察普萘洛尔治疗难治性婴幼儿血管瘤的临床疗效和安全性。方法:给予68例通过临床和辅助检查确诊的难治性婴幼儿血管瘤患儿口服普萘洛尔治疗,1.0～2.0 mg/(kg.d),分2～3次喂服,每月复诊1次,观察和记录血管瘤大小、质地、颜色的变化等,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:68例患儿服药3～13个月,疗效:I级8例;Ⅱ级13例;Ⅲ级29例;Ⅳ级13例。68例除1例因肝炎剔除,4例失访外,余均未发生严重不良反应,但无1例完全消退。结论:口服普萘洛尔治疗难治性婴幼儿血管瘤近期疗效好,不良反应轻微,可作为控制难治性婴幼儿血管瘤快速生长阶段的首选治疗药物。

Objective To evaluate the short-term efficacy and safety of propranolol for problematic infantile hemangiomas.Methods Oral propranolol was administered to 68 infants with heamngiomas diagnosed by clinical evaluation and adjuvant examination at 1.0~2.0 mg per kilogram of body weight per day,divided to 2 or 3 times.The patients revisited once a month.The changes of the tumor size,texture,and color 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-grade system.Results All the 68 infants were followed up for 3-13 months,except that 1 infants combined with other diseases and 4 withdrew.The overall response was Scale 1 in 8 infants,Scale II in 13,Scale Ⅲ in 29,and Scale IV in 13.No serious adverse effects were seen,but none cured entirely as well.Conclusion Oral propranolol is safe and effective for infantile heamngioma with good short-term result.It could be used as the primary drug for problematic infantile hemangiomas at the rapid growth stage of hemangiomas.