小儿特殊部位血管瘤的治疗及用药安全性评价

Efficacy and safety of pingyangmycin plus propranolol treatment for children with special parts hemangiomas

目的观察血管瘤内注射平阳霉素、地塞米松混合剂联合口服普萘洛尔治疗小儿特殊部位血管瘤的临床疗效并对其安全性进行评价。方法对38例特殊部位难治性血管瘤进行临床和超声评估，住院后用平阳霉素、地塞米松混合剂采取全身麻醉状态下瘤内注射治疗，术后第1天普萘洛尔顿服，用药后监测心率。住院观察1周，出院后继续口服普萘洛尔3～6个月。每半月至门诊观察瘤体变化，随访3～8个月。结果所有患儿在注射24h后血管瘤颜色和质地显示出即时效果，口服普萘洛尔2个月后复查超声提示肿瘤最大厚度平均缩小66．7％，均未见严重不良反应。结论平阳霉素、地塞米松混合剂联合口服普萘洛尔具有快速的治疗效果，可作为婴幼儿特殊部位难治性血管瘤的临床一线治疗方法。

Objective To evaluate the clinical efficacy and safety of local pingyangmycin and dexamethasone injection combined with oral propranolol for the treatment of paediatric refractory hemangi- oma. Methods After clinical and ultrasound evaluations, the 38 cases were given tumor injection with mixture of pingyangmycin and dexamethasone under general anesthesia. On the 1 st day after operation, propranolol 1 mg/kg was orally given. Then all children were observed for 1 week at hospital and given propranolol for 3 to 6 months after discharge. Propranolol treatment was continued and all cases returned to clinic every half a month. Followed up time was 3 to 8 months. Results After comprehensive exami- nation, the color and texture of all the hemangioma were displayed within 24 hours after injection. After 2 months treatment, ultrasound examination indicated that the average maximum thickness of the tumor reduced 66. 7%. No serious adverse effects were recorded in all cases. Conclusions Local pingyangmy- cin and dexamethasone injection combined with oral propranolol is effective on pediatric refractory heman- gioma, it could be regarded as a preferred management for infant refractory hemangioma.