马来酸噻吗洛尔滴眼液治疗婴幼儿表浅血管瘤的临床研究  

A clinical study of Timolol Maleate Eye Drops for the treatment of superficial infantile hemangiomas

作　　者：於林军[1] 许嘉川 苏宝利[2] 熊启星[1] 罗春芬[2] 

机构地区：[1]浙江大学附属儿童医院小儿外科,杭州310003 [2]温州医科大学附属台州医院小儿外科

出　　处：《中华整形外科杂志》2015年第6期440-445,共6页Chinese Journal of Plastic Surgery

摘　　要：目的 探讨马来酸噻吗洛尔滴眼液治疗婴幼儿表浅血管瘤的临床效果.方法 选取2012年4月至2014年5月符合纳入标准的婴幼儿表浅血管瘤病例210例,根据家属自愿的原则分为治疗组176例,等待观察的对照组34例.用无菌纱布蘸取马来酸噻吗洛尔滴眼液并覆盖于瘤体表面（药液浸透纱布的范围应大于或等于瘤体表面范围）,每日用药3-4次,作用时间＞20 min,随诊期限为3周、6个月,以清晰图片的方式记录瘤体治疗情况.治疗效果评定分为4级：Ⅰ级,无法控制瘤体生长;Ⅱ级,瘤体生长停滞;Ⅲ级,瘤体较前明显消退;Ⅳ级,瘤体外观完全消失.统计有效率（治疗效果达Ⅲ级以上病例数占总数的百分比）和治愈率（治疗效果达Ⅳ级的病例占总数的百分比）.应用SPSS 17.0统计软件进行数据处理和分析,分类变量采取卡方检验,P＜0.05为有统计学意义.结果 治疗组中有3例患儿瘤体周围出现湿疹样反应,1例患儿出现瘤体溃烂,不良反应发生率占2.3％.3月时随访,治疗组中154例瘤体生长停滞,颜色较前变暗,质地变软,厚度变薄;对照组中仅4例病例瘤体出现消退,18例瘤体较前颜色鲜艳,12例瘤体大小维持原状.6个月随访,治疗组中18例达到Ⅳ级标准,84例达到Ⅲ级,60例达到Ⅱ级,14例瘤体较前变大,为Ⅰ级标准,治疗有效率达58.0％,治愈率为10.2％;对照组中4例达到Ⅲ级标准,13例达到Ⅱ级,17例瘤体继续发展,为Ⅰ级标准,治愈率为0,有效率为11.8％.对照组治愈率及有效率明显低于治疗组,差异具有统计学意义（P＜0.05）.结论 应用马来酸噻吗洛尔滴眼液治疗婴幼儿表浅血管瘤,疗效较为确切,不良反应发生率低,安全性高,操作简便,可作为首选药物.Objective To discuss the clinical efficacy of Timolol Maleate Eye Drops in the treatment of superficial infantile hemangiomas.Methods From April 2012 to May 2014, 210 patients with superficial infantile hemangiomas were included.According to the parents＆#39; choice, a total of 176 cases were treated with Timolol Maleate Eye Drops as the treatment group, and the 34 cases who received the treatment of ＂wait and see＂ was included in the control group.In the treatment group, the gauzes were dipped into the eye drops and putted evenly on the surface of the hemangioma, 3-4 times daily and lasted for more than 20 minutes.The gauze should completely cover the surface of the tumor.The follow-up periods were 3 weeks and 6 months after treatment with the pictures to record the treatment effect.The therapeutic effect was graded as： grade Ⅰ （unable to control the growth of the hemangioma） , lⅡ （the growth of the hemangioma stagnated） , Ⅲ （hemangioma significantly subsided） , Ⅳ （the hemangioma completely disappeared）.The effective rate included the cases with grade Ⅱ and above grade Ⅱ.The cure cases included the cases with grade Ⅳ.The data was analyzed with the statistical software SPSS 17.0 and the Chi-square test（P ＜ 0.05）.Results 3 cases in the treatment group showed eczema action.Tumor ulcer happened in 1 case in treatment group.The side effect rate was 2.3％.The results at 3 weeks following in the treatment group showed that the growth of the hemangioma were stagnated in 154 cases.The color of hemangioma became darker in different degrees than before, and the texture of the hemangioma became soft in majority of children, and the thickness of hemangioma became thinner in some cases.However, only 4 cases showed the hemangiomas were subsided, 18 cases showed the color of the part of the hemangiomas were brighter than before, and 12 cases of the hemangiomas remained original state in the control group.The results of 6 weeks following the treatment showed that 18 patients in the tre

关 键 词：马来酸噻吗洛尔滴眼液 婴幼儿血管瘤 前瞻性研究 

分 类 号：R732.2[医药卫生—肿瘤]