激光杂志
激光雜誌
격광잡지
LASER JOURNAL
2012年
2期
63-64
,共2页
罗晓燕%甘立强%倪思利%王华
囉曉燕%甘立彊%倪思利%王華
라효연%감립강%예사리%왕화
普奈洛尔%婴幼儿%血管瘤
普奈洛爾%嬰幼兒%血管瘤
보내락이%영유인%혈관류
propranolol%infant%hemangiomas
目的：探讨口服普奈洛尔治疗婴幼儿血管瘤的疗效和安全性。方法：选取符合纳入标准的婴儿血管瘤59例,采用普奈洛尔2mg/kg.d,分2次口服,治疗开始前3天每天监测血压和心率,每月来医院随访照相并进行血管瘤严重程度视觉评分以评估疗效,同时常规体检包括血压、心率、血糖,并记录不良反应。结果：59例婴儿血管瘤中男21例,女38例,平均年龄5.08月。其中草莓状血管瘤4例,海绵状血管瘤8例,混合型血管瘤47例。病变位于四肢10例,躯干7例,头颈32例,其中口鼻周8例,眼周1例,溃疡型2例。大多数病例于服药48小时后皮损颜色变暗、皮温降低,随后瘤体开始逐渐缩小。治疗4周、8周时严重程度评分已降至5分、4分,表示瘤体平均消退达到50%、60%。普奈洛尔对草莓状、海绵状及混合型血管瘤的疗效无显著差异。此外,不同性别、起始治疗月龄、不同部位之间疗效无显著差异（P〉O.05）。生长于眼周、口鼻周及溃疡型的血管瘤同样对普奈洛尔治疗有效。治疗中未发现有症状的低血压、低血糖,1例发生腹泻,11例患儿出现睡眠改变,其中9例表现为夜惊,2例表现为睡眠增加。结论：2mg/kg.d普奈洛尔口服治疗婴儿血管瘤疗效显著,副作用小,可望成为血管瘤的一线治疗新方法。
目的：探討口服普奈洛爾治療嬰幼兒血管瘤的療效和安全性。方法：選取符閤納入標準的嬰兒血管瘤59例,採用普奈洛爾2mg/kg.d,分2次口服,治療開始前3天每天鑑測血壓和心率,每月來醫院隨訪照相併進行血管瘤嚴重程度視覺評分以評估療效,同時常規體檢包括血壓、心率、血糖,併記錄不良反應。結果：59例嬰兒血管瘤中男21例,女38例,平均年齡5.08月。其中草莓狀血管瘤4例,海綿狀血管瘤8例,混閤型血管瘤47例。病變位于四肢10例,軀榦7例,頭頸32例,其中口鼻週8例,眼週1例,潰瘍型2例。大多數病例于服藥48小時後皮損顏色變暗、皮溫降低,隨後瘤體開始逐漸縮小。治療4週、8週時嚴重程度評分已降至5分、4分,錶示瘤體平均消退達到50%、60%。普奈洛爾對草莓狀、海綿狀及混閤型血管瘤的療效無顯著差異。此外,不同性彆、起始治療月齡、不同部位之間療效無顯著差異（P〉O.05）。生長于眼週、口鼻週及潰瘍型的血管瘤同樣對普奈洛爾治療有效。治療中未髮現有癥狀的低血壓、低血糖,1例髮生腹瀉,11例患兒齣現睡眠改變,其中9例錶現為夜驚,2例錶現為睡眠增加。結論：2mg/kg.d普奈洛爾口服治療嬰兒血管瘤療效顯著,副作用小,可望成為血管瘤的一線治療新方法。
목적：탐토구복보내락이치료영유인혈관류적료효화안전성。방법：선취부합납입표준적영인혈관류59례,채용보내락이2mg/kg.d,분2차구복,치료개시전3천매천감측혈압화심솔,매월래의원수방조상병진행혈관류엄중정도시각평분이평고료효,동시상규체검포괄혈압、심솔、혈당,병기록불량반응。결과：59례영인혈관류중남21례,녀38례,평균년령5.08월。기중초매상혈관류4례,해면상혈관류8례,혼합형혈관류47례。병변위우사지10례,구간7례,두경32례,기중구비주8례,안주1례,궤양형2례。대다수병례우복약48소시후피손안색변암、피온강저,수후류체개시축점축소。치료4주、8주시엄중정도평분이강지5분、4분,표시류체평균소퇴체도50%、60%。보내락이대초매상、해면상급혼합형혈관류적료효무현저차이。차외,불동성별、기시치료월령、불동부위지간료효무현저차이（P〉O.05）。생장우안주、구비주급궤양형적혈관류동양대보내락이치료유효。치료중미발현유증상적저혈압、저혈당,1례발생복사,11례환인출현수면개변,기중9례표현위야량,2례표현위수면증가。결론：2mg/kg.d보내락이구복치료영인혈관류료효현저,부작용소,가망성위혈관류적일선치료신방법。
Objective：To investigate the efficacy and safety of oral propranolol for infantile hemangiomas.（IH）.Methods： 59 patients with IH were included in this study.The propranolol dose was 2.0 mg/kg.d divided BID.Blood pressure and heart rate were monitored one to three hours after taken the medicine per day within the first 3 days.The patients were asked for follow-up visit every month.The size,texture and color of the tumor were taken photoes and a photograph based serverity scoring assessement was performed.The blood pressure,heart rate and blood glucose were measured regularly and the side effect was also recorded.Results： Among 59 IH patients,there were 21 males and 38 females with a mean age of 5.08 months.4 cases are strawberry hemangiomas,8 cavernous hemangiomas and 47 mixed hemangiomas.The lesions were located in extremities（n=10）,trunk（n=7）,head and neck（n=32）.Special locations were perioral and nasal（n=8）,orbital（n=l）,ulceration（n=2）.After 48 hours propranolol treatment,most patients showed decreased skin temperature and darken in color of tumor surface.The average serverity score at 4 and 8 weeks follow-up was 5 and 4 respectively.Which means tumors decreased more than 50% and 60% respectively.No statistical differnences among strawberry,cavernous and mixed types hemangiomas were observed.Efficacy has independence with gender,onset age and location.Propranolol also has conspicuous effect on the lesions perioral and nasal,orbital and ulceration.No symptomatic low blood pressure or hypoglycemia was observed.There was one case of diarrhea,11 cases of sleep disorders.9 of 11 patients were noted to have agitated sleep.2 were observed to have hypersomnia.Conclusion： Oral propranolol therapy is a safe and effective therapeutic regimen for infantile hemangiomas with little side effects.It can be used as the first-line protocol chemotherapy.
