普萘洛尔小剂量口服治疗婴儿血管瘤的近期临床疗效及安全性

The evaluation of short-term efficacy and safty for treating infantile genabgiomas with low-dose propranolol

目的探讨普萘洛尔小剂量口服治疗婴儿血管瘤的近期临床疗效及安全性。方法回顾性分析本院2013年3月至2014年3月收治的154例血管瘤患儿的临床资料，所有患儿均口服普萘洛尔治疗，1．0～1．5mg／kg，顿服，1次／天，连续用药，服药期间住院7～10天，出院后继续服药，出院后每隔2周复诊1次，观察、记录患儿血管瘤大小、颜色、质地等变化，并及时处理患儿治疗期间的不良反应，根据4级评分法评价患儿的临床治疗效果及用药安全性。结果154例血管瘤患儿经普萘洛尔口服治疗24～48小时后，患儿瘤体张力不同程度减小、颜色变浅、体积变小，治疗5～7天变化最明显。154例患儿均能顺利完成治疗，其中疗效Ⅳ级（优）27例（17．53％），III级（好）87例（68．52％），II级（中）38例（24．68％），I级（差）2例（1．30％）。长疗程治疗效果优于短疗程（P〈0．05）；深部血管瘤治疗效果优于较浅表型血管瘤（P〈0．05）；但不同部位血管瘤的治疗效果不存在显著差异（P〉0．05）。主要不良反应包括腹泻76例（49．35％），心率减慢154例（100％）、睡眠状况改变46例（29．87％），均未对治疗产生严重影响，经对症处理后全部恢复正常。结论通过普萘洛尔小剂量口服治疗婴儿血管瘤，能够显著提高治疗效果，近期疗效确切，不良反应小，有助于改善患儿的生活质量，值得临床推广应用。

Objective To evaluate the short-term efficacy and salty for treating infantile genabgiomas with low-dose propranolol. Method 154 cases of infantile genabgiomas from March 2013 to March 2014 were gave oral propranolol, with a dose of 1.0 - 1.5 mg/kg, one time per day. All cases were hospitalized for 7 to 10 day, then continued medication at home and revisired every two weeks. The tumor size, color and texture changes were observed and managed accordingly. At last, we ecaluated the shor-term efficacy by using a four-point scale system. Result 154 cases all had smaller size, decreased color and density tumors after 24 - 48 hours medication. These changes had conspicuous during five to seven days post-medication. The overall response was scale IV （excellent） in 27 cases （17.53%）, scale III （good） in 87 cases （68.52%）, scale II （moderate） in 38 cases （24.68%）, scale I （poor） in 2 cases （1.30%）. Radit analysis showed that the cases by prolonged treatment or of deep-seated hemangiomas treatment had a better efficacy （P 〈 0.05）, but no significant difference was observed among different primary sites （P 〉 0.05）. No significant adverse reactions were observed, with diarrhea （49.35%）, bradycardia （100%）, sleep change （29.87%）, which resolved by expectant treatment without any significant sequel. Conclusion Oral propranolol treatment by a low dose is effective and safe regimen for infantile proliferating hemangiomas. The short-term efficacy is excellent and can significantly improve the live quality level, while the side effects are minimal. Thus is worthy of a wide clinical application.