口服普萘洛尔治疗40例面颈部婴幼儿血管瘤的临床观察

Clinical observation of propranolol taken orally to 40 cases of infantile haemangiomas

目的：评价普萘洛尔口服治疗婴幼儿血管瘤的临床疗效及不良反应.方法：对40例面颈部血管瘤患儿进行口服普萘洛尔治疗,并以32例强的松治疗的血管瘤患儿作对照.治疗组予口服普萘洛尔2mg/（kg·d）,分2次服用.住院治疗3-4天,为安全起见,第1天服全量的1/4,第2天服全量的1/2,第3天服全量.若无异常就可出院,且出院后继续按原剂量服药.每2-3周复诊1次,并观察瘤体的大小、质地、颜色,随访和同时针对药物的不良反应进行处置;对照组采用口服强的松3mg/（kg·d）,隔日1次,晨起时顿服,两组患者各自用药后,根据病变的生长、萎缩并稳定或服药时间满6个月为停药指征.按4级评分法（优、好、中、差）对近期疗效进行评价.结果：疗效统计,治疗组：优12例（30.00％）,好21例（52.50％）,中5例（12.50％）,差2例（5.00％）,有效率82.50％;对照组：优5例（15.62％）,好9例（28.12％）,中12例（37.50％）,差6例（1 8.75％）,有效率43.75％.治疗组与对照组的有效率比较差异有统计学意义（P＜0.05）.治疗组不良反应发生率7.5％,对照组为56.25％,两组比较差异有统计学意义（P＜0.05）.结论：普萘洛尔口服治疗婴幼儿血管瘤的方法有效,不良反应少,值得临床推广应用.

Objective To investigate the clinical efficacy and adverse effects of propranolol taken orally infantile haemangiomas.Methods Between February 2010 and February 2013,40 infants with heamangiomas were used as study group by using propranolol.At a dose of 2.0mg/（kg ·d）,by dividing into 2 times with continuous medication.The patients were hospitalized for 3-4 days.For security,the first day used 1/4 of the full does,the second day used 1/2 of full does,and the third day used the full does.If there was no abnormal phenomena,continued medication with former does after they leaved the hospital.Take a subsequent visit after 2-3 weeks,observing and recording the changes of tumor size,texture and color,the adverse effects after medication were observed and managed accordingly at a regular interval.32 infants with heamangiomas were used as control group materials by using prednisone.At a dose of 3mg/（kg ·d）,the next day before 8 am.Taken at a draught.After the treatment between these two groups,the withdrawal indications were the growth of tumor,the shrink and stabilize of tumor or taking time to 6 months.The short-term results were evaluated by using a 4-point scale system （excellent,good,moderate,poor）.Results In group of propranplol orally.The overall response of excellent were 12patients （30.00％）.good were 21patients （52.50％）.moderate were 5 patients （12.50％）,poor were 2 patients （5.00％） and the efficiency was 82.50％.n control group excellent were 5 patients （15.62％）.good were 9 patients （28.12）.moderate were 12 patients （37.50％）.poor were 6 patients （18.75）,and the efficiency was 43.75％.There was significant difference （P＜0.05）.between these two groups,analysis show that effect and adverse reactions of treatment group was better.There was significant difference （P＜0.05）of adverse reations rate between the treatment group（82.50％）and control group （43.75 ％）.Conclusion Oral propranolol is effective for infantile proliferating haemangioma.And the adverse effects are minimal.