外用β受体阻滞剂和脉冲燃料激光治疗低、中风险血管瘤的效果对比

Curative Effect Comparison of Topical Beta Receptor Blockers and Pulsed Fuel Laser Therapy for Low and Medium Risk Vascular Tumors

目的比较外用β受体阻滞剂和激光治疗低、中风险血管瘤的效果。方法将2018年10月—2021年9月本院收治的262例低、中风险婴幼儿血管瘤患者根据治疗方式分为脉冲燃料激光组(85例)、外用0.5%噻马洛尔组(91例)和外用2%卡替洛尔组(86例)。对比各组的疗效。脉冲燃料激光治疗采用595nm PDL联合1064nm Nd:钇铝石榴石(yttrium aluminum garnet,YAG),每月1次,持续治疗1~6月。其余两组将外用β受体阻滞剂湿敷于瘤体上,持续30min,每日湿敷2次。结果总有效率方面,激光组与噻马洛尔组的差异不明显,无统计学意义(P>0.05),但与卡替洛尔组相比,组间差异显著,有统计学意义(P<0.05)。激光组疗程为(3.47±1.46)月,明显快于外用β受体阻滞剂组,组间差异显著,有统计学意义(P<0.05)。噻马洛尔组的疗程(9.33±5.80月)较卡替洛尔组(5.57±2.57月)长,但噻马洛尔组有效率(85.4%)较卡替洛尔组(79.3%)高。三组血管瘤疗效与性别、风险等级没有相关性。浅表性血管瘤的疗效明显优于混合性。结论无论是脉冲燃料激光还是外用β受体阻滞剂均对低、中风险血管瘤有效。激光治疗较外用β受体阻滞剂控制快、疗程短。建议尽早开始治疗,最好在出生3月以内,并坚持用药保证一定的疗程,使治疗效果达到最优。

Objective To compare curative effect of topical beta receptor blockers and laser therapy on low and medium risk vascular tumors.Methods The paper studied curative effect of 85 cases in pulse fuel laser group,91 cases treated with 0.5%thiamol group,and 86 cases with 2%captoprolol group for low and medium risk vascular tumors by group controlled study.Pulsed fuel laser therapy was 595nm PDL combined with 1064nm Nd:YAG,once a month,with continuous treatment for 1-6 months.Topical beta receptor blocker was applied for the tumor with wet compress for 30 minutes,twice a day.Results Total effective rate showed no statistically significant difference between laser group and thiamol group(P>0.05),there was statistically significant difference between laser group and captoprolol group,(P<0.05).Treatment period of laser group was(3.47±1.46)months,significantly faster than topicalβ-receptor blocker,with statistical difference(P<0.05).Treatment course in thiamol group was 9.33±5.80 months,longer than 5.57±2.57 months in captoprolol group,effective rate in thiamol group was 85.4%,higher than 79.3%in captoprolol group.There was no correlation for curative effect of hemangiomas,gender and risk level of three groups.Curative effect of superficial hemangioma was significantly better than mixed hemangioma.Conclusion Pulsed laser and external useβreceptor blockers are effective for low and medium risk hemangiomas.Laser therapy has faster control and shorter treatment duration than topical beta receptor blockers.It is recommended to treat as soon as possible,preferably within 3 months after birth,and keep some certain treatment course of medication,to achieve the best curative effect.