普萘洛尔治疗婴儿血管瘤28例的临床观察

Clinical observation of Propranolol in the treatment of 28 cases of infant hemangioma

目的：探讨普萘洛尔治疗婴儿血管瘤的临床效果及用药安全性。方法对该院2010年1月至2011年12月收治的28例婴儿血管瘤采用口服普萘洛尔治疗。全组均按2 mg · kg -1· d-1，分9：00、17：00时点2次口服。服药后第1天严密监测心率，每4小时1次，第2天开始6～8h监测心率1次；用药第1天、第2天连续监测用药后1h末梢血糖，若血糖稳定，第3天开始每天测末梢血糖。住院1周后出院，详细交代家长务必遵照医嘱按时、按量服药，服药中若出现不适随时回院复诊；出院后每2周回院复查血常规，电解质，肝、肾功能，空腹血糖。结果 Achauer等分级标准评价疗效Ⅰ级0例，Ⅱ级0例，Ⅲ级9例，Ⅳ级19例，总有效率100％。心率变缓18例，均在基础心率的10％以内，未行处理。5例出现腹泻，经过对症处理后痊愈；3例在服药后出现胃肠道反应，服药后7～10 d缓解。无肝、肾功能损害，哮喘发作，血小板减少，高血钾，低血糖，兴奋等不良反应。结论普萘洛尔有能控制血管瘤生长，促进血管瘤消退，并且还具有不良反应轻的特点，可以作为血管瘤治疗的推荐药物。

Objective To investigate the clinical efficacy and safety of propranolol in the treatment of infantile hemangioma . Methods 28 infants admitted to our hospital from January 2010 to December 2011 with hemangioma underwent with oral prop-ranolol treatment .The whole group took the propranolol according to the criterion of 2 mg · kg -1 · d-1 ,and took the medicine two times a day ,namely 9 ：00 and 17 ：00 .On the first day after taking propranolol ,the heart rates were monitored every 4 hours ;from the next day on ,monitor the heart rate every 6-8 hours ;continuous monitoring of peripheral blood sugar 1 hour after taking prop-ranolol were carried out on the first and second day of taking propranolol ,and if the blood sugar were stable ,a daily monitoring of peripheral blood sugar would be implemented from the third day on .All patients were discharged one week after hospitalization , doctors′advices should involve details including the time and dose of taking medicine ,and if there were medicine discomfort ,pa-tients should come back for referral ;come back to the hospital two weeks after discharge to review blood count ,electrolytes ,liver and kidney function ,fasting blood glucose .Results Achauer grading standards evaluate the efficacy Class Ⅰ ：0 cases ;Ⅱ ：0 ;Ⅲ ：9 cases;Ⅳ grade：19 cases;efficiency reached 100% .18 cases showed heart rate slow ,all remained within 10% of the basis of heart rate ,and underwent no treatment .There were 5 cases of diarrhea ,healed after symptomatic treatment ;3 cases of gastrointestinal re-actions and reliaved 7 -10 days after taking the medicine .No adverse reactions like liver and kidney dysfunction ,asthma attacks , thrombocytopenia ,hyperkalemia ,hypoglycemia ,excitement ,etc occurred .Conclusion Propranolol can control the growth of heman-giomas ,promoting hemangioma regression ,and cause a light side reaction ,thus it can be used as the recommended drugs for treat-ment of vascular tumors .