普萘洛尔治疗婴幼儿血管瘤的临床效果评价  

Clinical evaluation of propranolol in the treatment of infantile hemangioma

作　　者：廖奕翔 王莹[3] 鲁旭飞 童磊[2] 周建华[2] 郭庆圆[2] 何宗轩 周元[5] 曹蕾 陈正岗[2,7] 

机构地区：[1]青岛大学,山东青岛266000 [2]青岛大学附属青岛市市立医院口腔科,山东青岛266071 [3]青岛大学附属医院儿童医学中心儿童重症医学科,山东青岛266000 [4]青岛即墨市普东卫生院口腔科,山东青岛266234 [5]潍坊医学院口腔医学院,山东潍坊261021 [6]大连医科大学口腔医学院,辽宁大连116044 [7]上海交通大学医学院附属第九人民医院口腔颌面外科,上海200011

出　　处：《中国医刊》2017年第9期85-88,共4页Chinese Journal of Medicine

基　　金：国家自然科学基金面上项目(81372908);山东省医药卫生科技发展计划面上项目(2016WS0319);青岛市医药科研指导计划(2015-WJZD013)

摘　　要：目的评价口服普萘洛尔治疗婴幼儿血管瘤的临床疗效及安全性。方法收集2013年9月至2015年9月在青岛市市立医院口腔颌面外科确诊为血管瘤的患儿52例,男10例,女42例,年龄2~26个月,平均(6.14±1.31)个月;头面颈部受累30例,四肢躯干受累16例,全身多处受累6例。所有患儿均采用口服普萘洛尔治疗,初始剂量为0.5mg/(kg·d),1日2次,间隔时间为8小时。最大维持剂量为2.0mg/(kg·d)。动态观察瘤体色泽与体积的变化及不良反应。结果 52例患儿全部完成治疗,治疗过程中出现腹泻4例、便秘6例,无严重不良反应者。疗效评定参照Achauer法,总有效率为94.23%,疗效Ⅰ级3例,Ⅱ级5例,Ⅲ级8例,Ⅳ级36例;颌面颈部与四肢躯干血管瘤疗效比较差异无显著性(P>0.05)。所有患儿均随访1年,未见复发者。结论普萘洛尔治疗婴幼儿血管瘤疗效明显、不良反应较少,可推荐为治疗婴幼儿血管瘤的一线用药。Objective To evaluate the clinical efficacy and safety of propranolol in treatment of infantile hemangioma （IH）. Method Medical records of 52 eligible patients were retrospectively analyzed, of which there were 10 males and 42 females. The mean age at start of treatment with propranolol was 6.14 months （range, 2-26 months）. There were 30 patients with infantile hemangioma in the skin of face and neck, 16 patients of extremities and trunk, 6 patients in multiple sites. The initiation dosage for patients was 0.5mg/（kg·d） for twice per day, followed by 2.0mg/（kg·d） in max maintenance doses. Dynamic monitoring in the treatment includes the IH changes in size and color and adverse drug reaction of propranolol. Result All 52 patients had completed the treatment uninterruptedly. The total effective rate was 94.23 %, with results including 3 patients of classⅠ（poor）, 5 patients of classⅡ（moderate）, 8 patients of classⅢ （good）, and 36 patients of classⅣ （excellent）, respectively 4 patients with diarrhea and 6 patients with astriction were found during the treatment. None of our patients showed severe side effects at the beginning of or during the treatment. There was no significant difference in curative effect between the group with hemangioma in face and neck and the other group for extremities and trunk. Recurrence was not observed after termination of treatment. Conclusion Our report supports the excellent effect and good tolerance of this novel therapy. We propose the use of propranolol as first-line treatment for IH.

关 键 词：普萘洛尔 血管瘤 婴幼儿 

分 类 号：R739.8[医药卫生—肿瘤]