595nm脉冲染料激光联合0.5%马来酸噻吗洛尔滴眼液治疗婴儿浅表性血管瘤临床疗效及安全性观察

Clinical Efficacy and Safety of 595 nm Pulsed Dye Laser Combined with Timolol Maleate Eye Drops in the Treatment of Superficial Infantile He-mangioma

目的:探讨单独应用595 nm脉冲染料激光、0.5%马来酸噻吗洛尔滴眼液及两者联合应用治疗婴儿浅表性血管瘤的临床疗效及安全性。方法:收集2019年1月至2019年12月来我院接受治疗的134例浅表性血管瘤婴儿作为研究对象,按照不同的治疗方案分为激光治疗组(n=54)、外用药物治疗组(n=42)和联合治疗组(n=38)。3组均在治疗后的第1、3、6个月时随访,通过拍照观察瘤体的变化情况,分析3组的有效率及不良反应。结果:3组患儿治疗后1、3、6个月时的有效率均存在统计学差异,表现为联合治疗组的治疗有效率高于激光治疗组和外敷药物组(均P<0.05)。3组疗效评价为有效及以上等级患儿的瘤体大小、质地、颜色等均有不同程度好转。激光治疗组、外用药物治疗组和联合治疗的不良反应发生率分别为22.2%、21.4%、15.8%,3组不良反应发生率之间差异无统计学意义(P>0.05);3组均无心率过低、血压异常、心律异常等严重不良反应或并发症出现。结论:595 nm脉冲染料激光联合外用0.5%马来酸噻吗洛尔作为治疗婴儿血管瘤的一种手段,具有确切的疗效、不良反应少、治疗安全有效的优点。对于远期效果及联合治疗的特点还有待进一步深入研究。

Objective: To investigate the clinical efficacy and safety of 595 nm pulsed dye laser, timolol maleate eye drops and their combination in the treatment of superficial infantile hemangioma. Methods: 134 infants with superficial hemangioma treated in our hospital from January 2019 to December 2019 were collected as study objects. According to different treatment schemes, the patients were assigned to the laser group(laser treatment, n=54), the medicine group(external medicine, n=42) and the joint group(the combined use of the above two, n=38). All the three groups were followed up at the first, third and sixth month after treatment. Changes in tumor body were observed by taking photos, and cure rates and adverse reactions were analyzed. Results: The proportion of the improved patients(cured + markedly effective+effective) 1, 3 and 6 months after treatment in the joint group were significantly higher than those in other two groups(P<0.05). Specifically, the size, texture and color of the tumor were improved. Incidences of adverse reactions were 22.2%, 21.4% and 15.8% in the laser group, the medicine group and the joint group, respectively;there was no statistically significant difference among the three groups(P>0.05). Serious adverse reactions/complications such as low heart rate, abnormal blood pressure and abnormal heart rhythm were not observed in three groups. Conclusion: The combined use of 595 nm pulsed dye laser and timolol maleate 0.5% is safe and effective in the treatment of infantile hemangioma for definite curative effect and less adverse reactions. Long-term effect and characteristics of the combined therapy need to be further studies.