小剂量盐酸普萘洛尔口服治疗不同月龄婴幼儿血管瘤临床疗效观察

目的 观察小剂量盐酸普萘洛尔口服治疗不同月龄婴幼儿血管瘤的临床疗效差别。方法 选取2011年1月—2012年5月在我院治疗的婴幼儿血管瘤患儿452例,分为0~6个月组(n=266)、7~12个月组(n=128)、13~18个月组(n=58),分别给予盐酸普萘洛尔1 mg/（kg·d）口服。服药3个月后复查,观察血管瘤颜色、大小、质地、表皮温度及超声下血流信号变化,对比不同月龄组临床疗效的差别。结果 0~6个月组患儿瘤体可见明显萎缩,颜色消退、皮温降低,超声下血流信号减少,服药24 h后即可见效;7~12个月组患儿亦可见上述变化,但血管瘤消退出现时间及速度较0~6个月组患儿明显延缓; 13~18个月组患儿血管瘤上述变化不明显,部分瘤体面积较大、生长期长的血管瘤亦可见一定程度上消退。结论 小剂量口服盐酸普萘洛尔治疗6个月以内处于快速增殖期的血管瘤效果明显;7~12个月患儿用药后可取得一定效果;1周岁以上小儿效果欠佳,需根据个体情况选择性应用。

Low-dose propranolol for treating infantile hemangiomas of various ages

PURPOSE: To investigate the treatment efficiency of low-dose propranolol for infantile hemangiomas. METHODS: A total of 452 infantile hemangioma patients admitted to our hospital from January 2011 to May 2012 were included in this study. The patients were divided into 0-6 months group (n=266), 7-12 months group (n=128), and 13-18 months group (n=58) according to their ages. All the patients received oral propranolol (1 mg/kg.d). Follow up was performed to determine changes of the color, size, texture of the hemangiomas, as well as the superficial temperature and the blood flow signals under ultrasonography. The efficiency of low-dose propranolol for infantile hemangiomas was analyzed and compared. RESULTS: For the 0-6 months group, satisfactory outcomes were found even 24 h after administration. Significant shrink was noted in the tumor mass of the infants. In addition, the color was faded, and the superficial temperature was decreased. Further more, the blood flow signals observed under ultrasound were decreased. Compared with the 0-6 months group, the symptoms of the 7-12 months group also showed alleviation; however, a significant delay was observed. For patients of 13-18 months, no significant improvement was discovered in the symptoms except for alleviation in part of the large size tumor and that with a long growing period. CONCLUSIONS: Low-dose propranolol is effective for treating infantile hemangioma patients aged 0-6 months at the proliferative period. Partial response was achieved in patients aged 7-12 months. The efficiency in patients aged 13-18 months was not satisfactory.