不同浓度普萘洛尔凝胶治疗婴幼儿血管瘤疗效观察

Effect of different concentrations of propranolol gel on infantile hemangiomas

目的 评价不同浓度普萘洛尔凝胶外涂治疗婴幼儿体表血管瘤的临床疗效及安全性.方法 将2011年3月至2012年9月南京军区福州总医院普通外科收治的63例婴幼儿体表血管瘤患儿随机数字表法分成A、B、C3组,每组21例,分别采用药物浓度为1％（20 g∶200 mg,A组）、2％（20 g∶400 mg,B组）和3％（20 g∶600 mg,C组）的普萘洛尔凝胶外涂治疗,以均匀涂抹瘤体表面为准,3次/d,随访治疗6个月.详细记录患儿性别、年龄、肿物部位、并发症以及血管瘤大小、质地、颜色、用药后不良反应以及停药后复发情况.涂药后每月返院复查并对疗效进行评价.结果 经过6个月的治疗,A、B、C3组患儿有效率分别为52.38％（11/21例）、57.14％（12/21例）、90.48％（19/21例）;彩超检查示3组患儿用药后血管瘤体厚度均明显变薄（P＜0.05）,3组患儿用药后除少数出现局部皮肤轻微病变外均无全身不良反应,且C组患儿明显优于其他2组（P＜0.05）.结论 普萘洛尔凝胶治疗婴幼儿血管瘤安全有效,3％浓度的普萘洛尔凝胶疗效要优于其他浓度组药物的疗效.

Objective To evaluate the efficacy and safety of different concentrations of propranolol gel in treatment of infantile hemangiomas（IH）.Methods Sixty-three consecutive infants with hemangiomas from Mar.2011to Sep.2012 in Department of General Surgery,Fuzhou General Hospital of Nanjing Military Command,were divided randomly into A,B,C groups and respectively treated with propranolol hydrochloride 1% （20 g ∶ 200 mg,A group）,2% （20 g：400 mg,B group）,3% （20 g：600 mg,C group）,evenly applied to the surface of the hemangiomas,3 times a day.Follow-up treatment was performed for 6 months.Details of adverse reactions,gender,age,tumor location,complications,and hemangioma size,texture,color and recurrence after stopping were recorded,and hospital review and efficacy evaluation were performed every month.Results After 6 months of treatment,A group had effective treatment in 11 patients（52.38%）,ineffective treatment in 10 patients （47.62%）,B group had effective treatment in 12 patients （57.14%）,ineffective treatment in 9 patients （42.86%）,and C group had effective treatment in 19 patients （90.48%）,ineffective treatment in 2 patients（9.52%）.After taking color Doppler ultrasound examination revealed IH thickness revealed significantly thinner.Conclusions External use of propranolol hydrochloride gel is an effective option for superficial hemangiomas,And 3% concentration of propranolol gel is superior to the efficacy of the other 2 drugs.