小剂量口服联合外涂普萘洛尔与脉冲染料激光治疗婴幼儿血管瘤的随机对照研究  

Randomized controlled study of low dose oral propranolol combination with gel versus pulsed dye laser in the treatment of infantile hemangioma

作　　者：黄建强[1] 陈剑伟[1] 许靖熠 张再重[1] 陈淑明[1] 黄庆锦 王烈[1] 黎成金[1] 

机构地区：[1]中国人民解放军南京军区福州总医院普通外科,福州350025

出　　处：《中国血管外科杂志（电子版）》2017年第2期106-108,116,共4页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：福建省科技厅社会发展重点项目(2011Y0042);福建省自然科学基金项目(2017J01216)

摘　　要：目的比较小剂量口服联合外涂普萘洛尔和595nm脉冲染料激光(PDL)治疗婴幼儿体表血管瘤的疗效与安全性。方法 68例临床诊断为婴幼儿体表血管瘤患儿,随机分为2组,其中PDL治疗组(34例)和普萘洛尔组(34例)。PDL治疗组行595nm PDL进行治疗;普萘洛尔组采用口服普萘洛尔加外涂普萘洛尔凝胶。结果普萘洛尔组均按计划完成治疗;PDL治疗组中31例按计划完成治疗。普萘洛尔治疗组总体有效率为94.12%,PDL治疗组的总体有效率为74.19%,差异有统计学意义(P=0.02),按Achauer分级标准比较两组差异也有统计学意义(P=0.01)。结论小剂量口服联合外涂普萘洛尔治疗婴幼儿体表血管瘤的疗效优于PDL治疗,可减少口服的药物剂量,缩短治疗时间,且不良反应较少。Objective To explore the efficacy and safety between of the low-dose oral propranolol combined with propranolol gel applied topically and the 595 nm pulsed dye laser(PDL) for infantile hemangiomas treatment. Methods Sixty-eight children with clinical diagnosis of cutaneous infantile hemangiomas were randomly divided into 2 groups, including PDL group(34 cases) and propranolol group(34 cases).Patients in PDL group were treated with 595 nm PDL while patients in Propranolol group were treated with propranolol by orally combined with external application of propranolol gel. Results All patients in Propranolol group completed the treatment according to plan. In PDL group, 2 patients quitted the treatment by various reasons of their relatives, and 1 patient was lost to follow-up. The total effective rate was 94.12% and74.19% in Propranolol treatment group PDL group, respectively(P =0.02). According to the Achauer classification standard, analysis using Wilcoxon rank sum test revealed significant difference of efficacy between two groups(P<0.01). Conclusion Therapy with low-dose oral propranolol combined with external application for cutaneous infantile hemangioma is effective with less side effects compared with PDL treatment.Combination with propranolol gel applied topically in the treatment of infantile hemangiomas can reduce dose of oral propranolol and shorten the treatment time.

关 键 词：脉冲染料激光 普萘洛尔 婴幼儿血管瘤 

分 类 号：R732.2[医药卫生—肿瘤]