普萘洛尔治疗溃疡性婴幼儿血管瘤18例临床分析

Propranolol in the treatment of ulcerated infantile hemangiomas: a clinical analysis of 18 cases

目的 :评价普萘洛尔治疗溃疡性婴幼儿血管瘤的临床疗效和安全性。方法 :选择2009年6月—2015年10月于中国医科大学附属口腔医院收治的18例并发溃疡的婴幼儿血管瘤患者,其中男7例,女11例。所有患儿均口服普萘洛尔,按1.0~1.5 mg/kg给药,每天1次顿服,连续给药3~12个月。每周复诊,至溃疡面完全愈合后改为每月复诊。动态观察并记录血管瘤大小、质地和颜色变化,溃疡面愈合情况、愈合时间,治疗结束或瘤体消退后有无瘢痕遗留。通过治疗期间出现的不良反应进行安全性评价。结果:18例患儿溃疡愈合时间为2~9周,平均3.96周;治疗时间为3~12个月,平均8个月;随诊时间8~24个月,平均17.8个月。2例患者遗留瘢痕。发现心率减慢、腹泻、溢奶、睡眠改变等不良反应,均未做特殊处理,未发生严重全身或局部不良反应。结论:口服普萘洛尔治疗溃疡性婴幼儿血管瘤能使溃疡面在短期内愈合,使血管瘤明显缩小,不良反应轻微,可作为治疗溃疡性婴幼儿血管瘤的首选方法。

PURPOSE： To evaluate the clinical efficacy and safety of oral propranolol in the management of ulcerated infantile hemangiomas （IHs）. METHODS： Oral propranolol was administered to 18 infants with hemangioma complicated by ulceration at a dose of 1-1.5 mg/kg of body weight per day. The treatment was continued for 3-12 months. Weekly visits were required until the ulcerations were healed, then changed to monthly visits. The therapeutic outcomes and safety were assessed by the changes of colors, size of tumor, healing of the ulcers and adverse effects throughout the course of treatment. RESULTS： Among 18 patients, ulcerations were healed within 2-7 weeks. The mean therapeutic duration was 8 months ranging from 3 to 12 months. Two of them left scars in the end of treatment. The main adverse effects were bradycardia, diarrhea, milk regurgitation, sleep disturbance, which resolved without special management. No major adverse effects were observed. CONCLUSIONS： Oral propranolol for ulcerated IHs can make the ulcer heal in a short time, and can significantly reduce hemangioma size; the adverse reactions were minimal.