普萘洛尔联合激光治疗婴幼儿体表血管瘤的疗效  

The therapeutic effect of propranolol with pulsed dye laser on infantile hemangioma

作　　者：曹梁[1] 李勤[1] 肖强[1] 周金华[1] 

机构地区：[1]广州军区总医院整形外科,广东广州510010

出　　处：《中国美容整形外科杂志》2013年第10期600-602,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨口服普萘洛尔结合脉冲染料激光治疗婴幼儿体表血管瘤的疗效和安全性。方法40例临床诊断为血管瘤的婴幼儿患者，随机分为2组，每组20例。第1组（普萘洛尔组）行口服普萘洛尔治疗，第2组（联合治疗组）行151服普萘洛尔＋瘤体局部脉冲染料激光治疗。服药方法：第1天0．5mg／kg，第2天1mg／kg，第3天及以后2—3mg／kg，分2次给药，进食后半小时服用。联合治疗组B超显示皮下无瘤体组织后使用脉冲染料激光治疗。结果普萘洛尔组有效率为85％，联合治疗组有效率为90％，两组差异有统计学意义。所有患儿开始服用普萘洛尔后第2～4天就可见病变颜色变浅，瘤体变软，伴有溃疡的患儿2个月后溃疡愈合。平均服药时间为7个月。联合治疗组脉冲染料激光治疗1～2次后消失。2例患儿治疗结束6个月后出现轻度复发，再次服药后有效。所有患者不良反应少且轻微。结论对于婴幼儿体表血管瘤，口服普萘洛尔结合脉冲染料激光治疗效果好，不良反应少，患儿家属满意度高。Objective To evaluate the therapeutic effect and safety of propranolol and pulsed dye laser for infantile hemangiomas （IH）. Methods 40 infants of hemangiomas were randomly divided into two groups. Group l were treated with propranolol, Group 2 were treated with propranolol and pulsed dye laser. Administra- tion： 0.5 mg/kg at the first day, 1 mg/kg at the second day, ,afterwards with a dose of 2 -3 mg/kgper day, given in 2 divided doses. Heart rate, breathe, and blood pressure were monitored during the first 1 week of treatment, in the absence of side effects, treatment was continued at home and revisited evel~~ 1 month. After the tumor is dissolve and uhrasonography test there is no survivals, the drug could stop gradually, and pulsed dye laser （PDL） was used to treat the angiotelectasis. Results The cured rate of eases treated with propranolol was 85%, and it was 90% in patients treated with oral propranolol and PDL. There was significant difference in curative effect between these two groups, Immediate effects on color, tensity, and size were noted in all cases. In ulcerated cases, complete healing occurred in 2 months. Treatment was administered for a mean total duration of 7 months, angiotelectasis disappeared after using PDL for one or two times. Relapses were mild and responded to retreatment. Side effects were limited and mild. Condusion Oral propranolol treatment incorporation with PDL is a safe and effective method for IH, the results were excellent and the side effects were minimal.

关 键 词：婴幼儿血管瘤 普萘洛尔 脉冲染料激光 

分 类 号：R739.5[医药卫生—肿瘤]