口服普萘洛尔联合局部激素注射治疗眶区严重婴幼儿血管瘤  

Oral propranolol with intralesional injection of steriods for severe periorbital infantile hemangioma

作　　者：黄莹滢[1] 欧阳天祥[1] 虞杰[1] 陈惠平[1] 肖燕[1] 刘军[1] 林军[1] 宋佳[1] 赵婷慧[1] 马晓荣[1] 

机构地区：[1]200092,上海,上海交通大学医学院附属新华医院,整形外科

出　　处：《中国美容整形外科杂志》2012年第3期135-137,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨普萘洛尔联合局部激素注射治疗眶区严重婴幼儿血管瘤的临床疗效.方法 根据病史、检查及MRI明确血管瘤诊断;确定无先天性心脏病和哮喘,先服用普萘洛尔,1、2d内进行眶区血管瘤瘤体内激素联合氨甲蝶呤注射.初次口服普萘洛尔0.75～1.00mg/kg,2次/d,治疗有效即维持开始治疗剂量不变,连续服用15～18个月.每隔1～3个月复查血糖及甲状腺功能指标.依据病灶大小、范围,配制得保松与甲氨蝶呤混合注射液,直接穿刺血管瘤间质内,回抽无血后注射至瘤体内.结果 本组15例患儿治疗后第1天瘤体开始缩小,治疗1周左右缩小明显,随访12～18个月,所有患儿血压、心率、血糖、甲状腺功能等无异常,仅1例患儿有轻度腹泻3d,未经治疗1周自愈.瘤体基本消退,睁眼恢复正常.瘤体不再生长,大部分消退.结论 普萘洛尔联合局部激素注射治疗眶区严重婴幼儿血管瘤,早期能迅速安全控制血管瘤生长并加速消退,不良反应明显减少,可作为治疗眶区严重婴幼儿血管瘤的首选治疗方法.Objective To explore the clinical effect of severe periorbital infantile hemangioma treated with propranolol combined with intralesional injection of steriods. Methods According to the history, clinical manifestation and MRI, diagnosis of infantile hemangioma was confirmed, exclude the congenital cardiac disea- ses or asthma. Oral propranolol and intralesional injection of Diprospan with Methotrexate（MTX） in 1-2 days. The initial dosage of propranolol is 0.75-1.0 mg/kg per day （twice a day in an interval of every 12 hours） and stick to the dosage if it showed signs of efficacy. Keep the dosage continously for 15-18 months. Check blood glucose and thyroid functions every 1-3 months. Adjust the formula of Diprospan with Methotrexate （MTX） ac- cording to the size and range of lesion and directly inject into the mesenchyma of hemangioma with no blood withdrawing. Results The periorbital lesions of 15 cases began to shrink immediately after the fist day and ob- viously decreased in one week. All the periorbital lesions began. After 12-18 months follow-up, there was no abnormalities in blood pressure, heart rate, blood glucose or thyroid functions. One case suffered from light di- arrhea for 3 days and spontaneously relieved in 1 week. Hemangiomas were diminished and eyelids well-opened with no recurrence. Conclusion Propranolol combined with intralesional injection of steriods can stop the growth of lesion and accelerate the speed of diminishing in a rapid, and remarkably reduces the side effects. It can be a first-line therapy for the treatment of severe periorbital infantile hemangioma.

关 键 词：婴幼儿血管瘤 眶区 普萘洛尔 激素注射 

分 类 号：R732.2[医药卫生—肿瘤]