小剂量普萘洛尔治疗特殊部位婴幼儿血管瘤的疗效观察

Clinical observation on the efficacy of a low-dose propranolol in the treatment of infantile hemangioma at special parts

目的：观察小剂量普萘洛尔治疗特殊部位婴幼儿血管瘤的临床疗效及不良反应。方法30例特殊部位婴幼儿血管瘤，入院检查排除治疗禁忌，予以口服小剂量（2 mg· kg-1· d－1）普萘洛尔，每日8：00、20：00服药，第1天喂1／2剂量，第2天喂2／3剂量，第3天喂正常剂量，持续心电监护及指脉氧监测，观察记录瘤体大小、颜色、张力等变化并拍照存档，以评估疗效。每2周复查血常规、空腹血糖、肝肾功能，并记录不良反应。结果口服小剂量普萘洛尔72 h内，所有瘤体的颜色、张力均有不同程度减轻。随访3～12个月，疗效评价为痊愈19例（63．3％），显效5例，有效6例，显效率80．0％，有效率100％。主要不良反应为心率变缓12例，未行特殊处理；短期腹泻6例，对症治疗后痊愈。无血糖异常等不良反应。结论小剂量普萘洛尔治疗血管瘤，疗效显著且不良反应轻，为特殊部位婴幼儿血管瘤的有效疗法。

Objective To observe the clinical efficacy of a low-dose propranolol in the treatment of infantile he-mangioma at special parts.Methods A total of 30 infants admitted into our hospital due to hemangioma at special parts were included into the current study.After exclusion of contraindication through medical examination, they were orally administrated with a low dose of propranolol （2 mg· kg-1 · d-1 ） at 8：00 and 20：00 o′clock.Their daily doses were in-creased from a half dose on Day 1, a two-thirds dose on Day 2 to a normal dose on Day 3.Meanwhile, electrocardio-graphy was continuously performed and pulse oxygen was monitored.Then, patients under stable conditions were dis-charged, and their parents were educated about the requirements of administration and recording any change in hemangio-ma size, color and tension with photos.The patients returned to the hospital every two weeks for blood routine test, re-examination of fasting blood glucose and liver and kidney function, and recording adverse reactions.Results All pa-tients presented relieved tension and lightened color in hemangioma to various degrees within 72 hours after administra-tion.They were followed up visited for 3 to 12 months.There were 19 recovery cases, 5 improved cases and 6 effective cases, with a recovery rate of 63.3%, an improvement rate of 80.0%and an effective rate of 100%.The main adverse reactions were showed heart rate in 12 patients, without special treatment, and short-term diarrhea in 6 patients which was cured after symptomatic treatment.No adverse reactions like abnormal blood glucose were reported.Conclusions A low-dose propranolol is effective to treat infantile hemangioma, with little adverse reaction, which can be adopted as a recommended method for treatment of infantile hemangioma at special parts.