不同方案^(90)Sr敷贴联合噻吗洛尔滴眼液外敷治疗婴幼儿血管瘤的疗效观察

Therapeutic efficacy of different regimens of ^(90)Sr application combined with external application of Timolol Maleate Eye Drops on infantile hemangioma

目的探讨不同方案^(90)Sr敷贴联合噻吗洛尔滴眼液外敷治疗婴幼儿血管瘤(IH)的临床疗效及不良反应。方法将120例IH患儿(138个病灶)随机分为A、B、C、D 4组,每组30例。A组(34个病灶)^(90)Sr敷贴治疗总剂量为10~25 Gy,分8次完成,每次治疗间隔1~2 d;B组(39个病灶)^(90)Sr敷贴治疗同A组,同时联合使用噻吗洛尔滴眼液外敷;C组(33个病灶)敷贴治疗总剂量为A组总剂量的80%(即8~20 Gy),分4次完成,每次治疗间隔5~7 d;D组(32个病灶)^(90)Sr敷贴治疗同C组,同时联合使用噻吗洛尔滴眼液外敷。第一疗程未愈者间隔3~4个月后行第二疗程治疗。比较各组的临床疗效及不良反应发生情况。结果第一疗程治疗总有效率为97.83%(135/138),2个疗程的治疗总有效率为99.16%(118/119)。第一疗程时,B组的疗效优于A组,D组的疗效优于C组(均P<0.05),但A组与B组间、C组与D组间2个疗程的总疗效差异均无统计学意义(均P>0.05);A组与C组间、B组与D组间第一疗程疗效和2个疗程的总疗效差异均无统计学意义(均P>0.05)。4组不良反应发生率差异无统计学意义(P>0.05)。结论4种治疗方案治疗IH患儿均有效、安全,但首个疗程采用^(90)Sr敷贴联合噻吗洛尔滴眼液外敷可以提高IH的治疗效果,临床上可个体化选择合适的治疗方案。

Objective To explore the clinical efficacy and side effects of different regimens of^(90)Sr application combined with external application of Timolol Maleate Eye Drops on infantile hemangioma(IH).Methods A total of 120 children with IH(138 lesions)were randomly divided into four groups:groups A,B,C and D,with 30 cases in each group.Group A(34 lesions)received^(90)Sr application with a total dosage of 10-25 Gy for eight times at 1-to-2-day intervals;group B(39 lesions)received^(90)Sr application therapy as the procedure in group A,and combined use of external application of Timolol Maleate Eye Drops;group C(33 lesions)received^(90)Sr application for four times at 5-to-7-day intervals,with a total dosage(8-20 Gy)equivalent to 80%of the total dosage in group A;group D(32 lesions)received^(90)Sr application therapy as the procedure in group C,and combined use of external application of Timolol Maleate Eye Drops.Patients who did not recover from the first course of treatment received the second course of treatment after an interval of 3 to 4 months.Clinical efficacy and incidence of adverse reactions were compared among groups.Results The total effective rate was 97.83%(135/138)after the first course of treatment and 99.16%(118/119)after the second course of treatment.In the first course of treatment,group B obtained superior efficacy than group A,and group D obtained superior efficacy than group C(all P<0.05),whereas no statistically significant difference was found in total efficacy after the second course between group A and group B,or between group C and group D(all P>0.05);there was no statistically significant difference in total efficacy after the first or second course between group A and group C,or between group B and group D(all P>0.05).There was no statistically significant difference in incidence rate of adverse reactions among the four groups(P>0.05).Conclusion All of the four treatment regimens are effective and safe in the treatment of IH children,however,the first course of treatment using^(90)Sr application combined with Timolol Maleate Eye Drops can improve the therapeutic effect on IH.Clinically,the option of appropriate treatment regimen can be performed individually.