口服普萘洛尔治疗婴幼儿眶周血管瘤临床疗效观察  

Oral propranolol for treatment of periorbital infantile hemangiomas

作　　者：薛雷[1] 刘子玫 徐大朋[1] 佟爽[1] 程晨[1] 宫贺 王绪凯[1] 

机构地区：[1]中国医科大学口腔医学院口腔颌面外科,辽宁省口腔医学研究所,口腔颌面外科研究室,辽宁沈阳110002

出　　处：《中国口腔颌面外科杂志》2016年第2期140-143,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：辽宁省教育厅资助项目(2009A747)

摘　　要：目的：评价口服普萘洛尔治疗婴幼儿眶周血管瘤的临床疗效与安全性。方法 ：2012年5月—2014年1月,30例婴幼儿眶周血管瘤患儿接受并完成口服普萘洛尔治疗。其中男10例,女20例;年龄2～13个月,平均4.8个月。服药剂量1.0～1.5 mg/kg,每天1次顿服。治疗时间4～38周,平均疗程19周。第1次复诊为2周,以后每个月复诊1次,定期拍照、记录血管瘤的颜色、质地、大小变化,观察并及时处理治疗期间的不良反应,按4级评分法对疗效进行评价。结果：随访3～10个月,疗效评定结果Ⅰ级（差）0例,Ⅱ级（中）2例,Ⅲ级（好）9例,Ⅳ级（优）19例。所有患儿服药30 min后均出现心率减慢,血压降低,2 h后达高峰,12 h后恢复正常,无任何临床症状。4例患儿出现轻度腹泻,1例出现睡眠改变,未见严重不良反应。结论：口服普萘洛尔治疗婴幼儿眶周血管瘤起效快,疗效显著,耐受性好,不良反应轻微,可作为首选治疗方法。PURPOSE： To assess the efficacy and safety of propranolol in the management of periorbital infantile hemangiomas. METHODS： Between May 2012 and January 2014, oral propranolol was applied to 30 infants with periorbital hemangiomas at a dose of 1.0-1.5 mg/kg taken once daily. There were 10 males and 20 females aging from 2 to13 months with a mean age of 4.8 months. The mean duration of treatment was 19 weeks（4 to 38 weeks）. The first followup visit was performed 2 weeks after therapy and scheduled monthly thereafter. The changes of the tumor size, texture and color were monitored and recorded at a regular interval. The adverse effects after medication were observed and managed accordingly. The treatment response based on improvement in volume, color, and texture after treatment was classified using a 4-point scale system. RESULTS： All patients were followed up from 3 to 10 months. The overall response was scale Ⅰ（poor） in 0 patient,scale Ⅱ（moderate） in 2 patients,scale Ⅲ（good） in 9 patients, and scale Ⅳ（excellent） in 19 patients. In all 30 infants, heart rates and blood pressure decreased 30 minutes post-medication and reached the peak within 2 hours. However, all these signs disappeared after taking propranolol for more than 12 h, and none required special treatment. Other side effects were observed in four patients involving diarrhea and one concerning sleep change.CONCLUSIONS： Oral propranolol was an effective and safe treatment for infantile periorbital hemangiomas, particularly early intervention suitable for severe periorbital proliferating infantile hemangiomas.

关 键 词：血管瘤 普萘洛尔 眶周 

分 类 号：R739.7[医药卫生—肿瘤]