0.5%马来酸噻吗洛尔滴眼液局部封包联合持续加压法治疗婴儿血管瘤疗效评价

Safety and Efficacy of Occlusion Therapy Combined with Continuous Compression of Timolol Maleate 0.5%Eye Drops for Deep or Mixed Infantile Hemangiomas

目的:评价0.5%马来酸噻吗洛尔滴眼液局部封包联合持续加压法治疗婴儿深部或者混合型血管瘤的疗效和安全性。方法:共70例深部或者混合型血管瘤婴儿入组并最终完成研究。其中34例接受噻吗洛尔滴眼液封包治疗(封包治疗组),36例患儿接受马来酸噻吗洛尔滴眼液联合局部加压治疗(联合治疗组)。封包治疗法每晚进行,每次封包8~10 h。联合治疗法是噻吗洛尔封包治疗的同时进行持续加压治疗,每次包8~10 h。治疗2、6和12个月进行评估,观察疗效及不良反应。结果:治疗前,封包治疗组和联合治疗组瘤体平均深度分别为(5.28±1.21)mm和(4.90±1.04)mm,两组比较差异无统计学意义(t=1.91,P=0.171);治疗2个月后,封包治疗组和联合治疗组瘤体深度为(4.31±1.33)mm和(3.10±0.90)mm,较治疗前明显变薄(均P<0.01),治疗6个月后,两组平均深度为(2.98±1.03)mm和(1.34±0.60)mm,较治疗前和治疗2个月明显变薄(均P<0.01);治疗2个月、6个月时联合治疗组的瘤体深度较封包治疗组明显变薄(均P<0.05)。治疗前封包治疗组和联合治疗组瘤体平均面积分别为(7.18±2.85)mm^(2)和(7.13±2.25)mm^(2),两组比较差异无统计学意义(t=0.70,P=0.148)。治疗2个月后,封包治疗组和联合治疗组瘤体面积为(5.86±2.85)mm^(2)和(5.24±1.72)mm^(2),较治疗前明显减小(均P<0.01),治疗6个月后两组瘤体面积为(4.39±2.38)mm^(2)和(2.75±1.18)mm^(2),较治疗前和治疗2个月时明显变小(均P<0.05);治疗2、6个月,联合治疗组的瘤体面积较封包治疗组明显变小,差异有统计学意义(P=0.021;P=0.003)。治疗12个月时,封包治疗组治愈率为50.0%,而联合治疗组为80.6%,两组比较差异有统计学意义(P<0.05)。结论:长时间加压联合封包噻吗洛尔滴眼液治疗混合型或者深部血管瘤疗效确切,且经济、方便。

Objective To evaluate the efficacy and safety of occlusion therapy combined with continuouscompression of timolol maleate 0.5%eye drops for the treatment of deep or mixed infantile hemangiomas(IH).Methods Totally 70 infants with deep or mixed IHtreated with timolol maleate 0.5%eye drops were divided in three groups:the occlusion therapy group(n=34)and the combination therapy group(n=36).The occlusion groupwas treated once daily under long duration occlusion for 8-10 hours on the night.The combination group was treated with both occlusion and compression therapy on the night for 8-10 hours.Efficacy and adverse reactions were observed 2,6 and 12 months after the treatment.Results Among three groups,there were no difference betweenthe depth and area of hemangiomas before the treatment(all P<0.01).The depth in occlusion and combination groups decreased significantly from(5.28±1.21)mm and(4.90±1.04)mm before the treatment to(4.31±1.33)mm and(3.1±0.90)mm two months after the treatment,and(2.98±1.03)mm and(1.34±0.60)mm six months after the treatment(all P<0.01).The depth in the occlusion group two and six months after the treatment were significantly deeper than those in the combination group(all P<0.05).The area in occlusion and combination groups decreased significantly from(7.18±2.85)mm^(2) and(7.13±2.25)mm^(2) before the treatment to(5.86±2.85)mm^(2) and(5.24±1.72)mm^(2) two months after the treatment,and(4.39±2.38)mm^(2) and(2.75±1.18)mm^(2) six months after the treatment(all P<0.01).The areas in combination group 2 and 6 months after the treatment was smaller than that in occlusion group(P=0.021,P<0.003).The cure rate 12 months after the treatment in the combination group(80.6%)was significantly higher than that in the occlusion group(50.0%)(P<0.05).Conclusion Compression combined with occlusion can increase the efficacy oftimolol in the treatment of deep or mixed IH,which is effective,safe and convenient.