普萘洛尔治疗并发溃疡婴幼儿血管瘤11例的临床观察

Clinical observation of propranolol for the treatment of infantile hemangioma with ulceration

目的评价普萘洛尔治疗婴幼儿并发溃疡血管瘤临床疗效和安全性。方法 11例并发溃疡的婴幼儿血管瘤患者口服普萘洛尔,起始剂量每天1.0mg/kg,12小时给药一次;每天递增0.5mg,至第3天以后维持每天2.0mg/kg,连续服用3～5个月。溃疡创面从治疗开始每日换药一次。每周复诊,动态观察和记录血管瘤溃疡创面情况以及瘤体大小、质地、颜色的变化。结果 11例患儿随访7～10月,8例瘤体缩小75%～100%,3例缩小50%～75%。血管瘤溃疡创面均在2～3周内愈合。发现心率减慢、腹泻、溢奶、睡眠改变等不良反应,均未需做特殊处理,2周内好转,未发现严重不良反应。结论口服小剂量普萘洛尔治疗婴幼儿并发溃疡血管瘤,能使溃疡创面在短期内愈合,并能使血管瘤体明显缩小,不良反应轻微。

bjective To evaluate the efficacy and safety of propranolol for the treatment of infantile hemangioma with ulceration.Method Oral propranolol was administered to 11 infants with hemangioma complicated by ulceration at a initial dose of 1.0 mg/kg of body weight per day. Medication was given every 12 hours, increasing 0.5 every day, to 2.0 mg/kg per day and 3 days latet the propranolol treatment was contituted for 3-5 months. Ulcers from treatment started a daily dressing change. Weekly visits, dynamic observation and recording hemangioma ulcers and tumor size, texture and color changes were done. Results Among the 17 patients treated,the follow-up time was 5-10 months. Hemangioma body reduced 75%-100% in 8 cases, 50%-75% in 3 cases. Hemangioma ulcers were all healed in 2-3 weeks. The main adverse effects were bradycardia, diarrhoea, spilled milk, changes in sleep, which resolved without special handling within two weeks.No serious adverse effect was observed. Conclusions Oral small dosage propranolol for infantile hemangioma complicated ulcers can make the ulcer heal in a short term, and can significantly reduce the hemangioma body, and the adverse reactions were minimal.