4%盐酸普萘洛尔乳膏局部治疗浅表型血管瘤的疗效观察  

The application of 4% propranolol cream in treating infantile local superficial hemangioma

作　　者：翁文骏[1] 黎阳[1] 方建培[1] 熊稀霖[1] 彭晓敏[1] 刘利婷 WENG Wenjun;LI Yang;FANG Jianpei;XONG Xilin;PENG Xiaomin;LIU Liting.(Department of Pediatric Ontology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China)

机构地区：[1]中山大学孙逸仙纪念医院儿童肿瘤专科,广州510120

出　　处：《中国小儿血液与肿瘤杂志》2018年第3期124-126,136,共4页Journal of China Pediatric Blood and Cancer

摘　　要：目的评价4%盐酸普萘洛尔乳膏局部治疗浅表型婴儿血管瘤的疗效和安全性。方法 48例浅表型血管瘤患儿年龄1～6个月35例,7～12个月13例,分为治疗组(24例,给予4%盐酸普萘洛尔乳膏局部涂抹,3次/d)和观察组(24例,不做任何治疗),临床疗效评价分级:Ⅰ:无效(继续生长);Ⅱ:控制生长;Ⅲ:瘤体缩小<25%;Ⅳ:瘤体及皮损颜色消退≥25%～50%;Ⅴ:瘤体及皮损颜色消退≥51%～75%;Ⅵ:皮损消退>75%,瘤体消失及病损皮肤恢复或接近正常肤色。有效率以Ⅲ级及以上计算。结果治疗组治疗4个月后Ⅰ级1例(4.2%)、Ⅱ级5例(20.8%)、Ⅲ级3例(12.5%),Ⅳ级11例(45.8%)、Ⅴ级3例(12.5%)、Ⅵ级1例(4.2%),仅发现2例患儿用药后出现一过性皮肤微红,短暂停药3d后,继续用药无不良反应,未观察到其他不良反应。观察组:Ⅰ级17例(70.8%)、Ⅱ级6例(25.0%)、Ⅲ级1例(4.2%),Ⅳ级0例(0%)、V级0例(0%)、Ⅵ级0例(0%)。治疗4个月时治疗组总有效率75%,观察组总有效率4.2%,差异有显著性(P<0.05)。结论 4%普萘洛尔乳膏局部应用治疗婴儿血管瘤,安全有效,对浅表小面积的婴儿血管瘤尤其适用,可减少全身应用毒副作用,且使用更方便,值得临床推广和应用。Objective To evaluate the efficacy and safety of 4% propranolol hydrochloride cream in treating infantile local superficial hemangioma. Methods 48 children with superficial hemangioma were enrolled in this study, with 35 children at the age of 1 -6 months and 13 children at the age of 7-12 months. All patients were divided into treatment group （24 cases, given 4% propranolol hydroehloride cream, 3 times/d ） and control Group （24 cases, no treatment ）. Clinical efficacy evaluation was graded in six levels. Level Ⅰ ： no effect with continuous tumor growth. Level Ⅱ ： limited tumor growth. Level. Ⅲ ： tumor mass reduced by less than 25%. Level Ⅳ： skin color and tumor mass reduced by ≥25% -50%. Level Ⅴ： skin color and tumor mass drop by 51% -75%. Level VI： Skin loss subsided by more than 75% , tumor mass disappeared and lesion skin recovered with skin color back to normal complexion. Efficiency was calculated by dividing the number of patients reaching Level m and above by the total number of patients. Results After 4-month treatment, the efficacy results were： 1 patient at level Ⅰ （4.2%）, 5 patients at level Ⅱ 5 （20.8%）, 3 patients at level Ⅲ （12.5%） 11 patients at level Ⅳ （45.8%）, 3 patients at level Ⅴ （ 12.5% ）, and 1 patients at level Ⅵ （4.2%）. Only 2 patients experienced reddish skin at the beginning of the treat-ment. The adverse effect disappeared after the medicine was stopped for three days and it didn＇ t reappear even with the resumption of treatment. In the control Group, 17 patients were at level Ⅰ（70. 8% ）, 6 patients at level Ⅱ （25%）, and 1 patient at level Ⅲ （4.2%）. No patient reached level Ⅳ or above. The total effective rate of the treatment group was 75% in 4 months while that was only 4. 2% in the control group. Statistical analysis showed that this difference was statistically significant （P 〈 0.05 ）. Conclusions The application of 4% propranolol cream in treating infantile hemangioma is very effective

关 键 词：普萘洛尔乳膏 浅表型血管瘤 婴儿血管瘤 

分 类 号：R732.2[医药卫生—肿瘤]