激光联合口服普萘洛尔治疗小儿血管瘤的疗效观察

Efficacy of laser therapy combined with oral administration of propranolol in the treatment of hemangioma in children

目的观察激光联合口服普萘洛尔治疗小儿血管瘤的疗效。方法选取103例血管瘤患儿为研究对象,随机分为两组,对照组口服普萘洛尔治疗的同时皮损处予以双波长激光治疗,每月1次,观察组先给予口服普萘洛尔治疗,至瘤体不因继续服药而消褪时停药,再行激光治疗。记录两组治疗瘤体变化情况,治疗结束后6个月比较两组疗效、临床指标、血流动力学指标及不良反应。结果观察组临床有效率(84.21%)高于对照组(78.43%),差异有统计学意义(χ^(2)=3.98,P<0.05)。治疗前,两组瘤体面积及瘤体厚度比较,差异均无统计学意义(t分别=1.81、1.77,P均>0.05),治疗结束后6个月,观察组瘤体面积及瘤体厚度明显低于对照组,差异有统计学意义(t分别=6.75、9.53,P均<0.05),观察组治疗时间明显短于对照组,差异均无统计学意义(t=7.76,P<0.05)。治疗结束后6个月,观察组血流峰值明显低于对照组,阻力系数明显高于对照组,差异均有统计学意义(t分别=3.08、2.09,P均<0.05)。两组不良反应发生率比较,差异无统计学意义(χ^(2)=1.73,P>0.05)。结论普萘洛尔可有效控制小儿血管瘤增长,促进消退,但不宜长期服用,在符合停药指征时及时停药并配合激光治疗有助于提高临床疗效,降低不良反应。

Objective To observe the efficacy of laser therapy combined with oral administration of propranolol in the treatment of hemangioma in children. Methods Totally 103 children with hemangioma were selected as the research subjects and randomly divided into two groups.The control group was treated with propranolol orally and dual-wavelength laser once a month on the skin lesions,and the observation group was given oral propranolol treatment at first,performed drug withdrawal until the fluid did not fade due to continued medication and then were given laser therapy.The changes of tumor were recorded in the two groups,and the efficacy,clinical parameters,hemodynamic parameters and adverse reactions of the two groups were compared at 6 months after the end of treatment. Results The clinical effective rate was 84.21% in the observation group,which was higher than 78.43% in the control group(χ^(2)=3.98,P<0.05).Before treatment,there were no statistical differences in tumor area and tumor thickness between the two groups(t=1.81,1.77,P>0.05).At 6 months after the end of treatment,the tumor area was smaller and thickness was thinner in the observation group(t=6.75,9.53,P<0.05),and the treatment time was significantly shorter than that of the control group(t=7.76,P<0.05).At 6 months after the end of treatment,the peak blood flow of the observation group was significantly lower than that of the control group,while the resistance coefficient was significantly higher than that of the control group(t=3.08,2.09,P<0.05).There was no statistical significance in the incidence rate of adverse reactions between the two groups(χ^(2)=1.73,P>0.05). Conclusion Propranolol can effectively control the growth of children’s hemangioma and promote its regression,but it is not suitable for long-term use.Timely drug withdrawal in accordance with indications of drug withdrawal and combining with laser therapy can help enhance the clinical efficacy and reduce the adverse reactions.