| 摘要: |
| 目的：探讨口服盐酸普萘洛尔治疗婴幼儿外阴血管瘤的效果。方法：选取2013年3月至2014年2月来我院儿科门诊就诊的外阴血管瘤患儿7例，包括溃疡型2例和非溃疡型5例，均给予盐酸普萘洛尔：首日剂量0.5 mg/（kg·d），分2次口服；第二天剂量增加为0.75 mg/（kg·d），分2次口服；第三天剂量调整为1 mg/（kg·d），分2~3次口服；服药1周后复诊观察患儿皮损变化情况及对药物的敏感程度，酌情加量至1.5~2.0 mg/（kg·d）维持，连续服用6~12个月，每天分2~3次口服。服药期间每月复诊1次，复查血常规、血糖、血压、心电图、B超，每2~3个月复查心肌酶谱、肝肾功能、电解质等。撤药时逐渐减量，每月减量0.5 mg/（kg·d）。患儿治疗前均完善影像学、生化检查及眼底检查，治疗过程中进行多普勒超声检查并观察皮损大小等以监测疗效。观察临床疗效及转归情况。结果：2例溃疡型血管瘤在服药1周后溃疡面逐渐愈合，1个月后完全愈合，形成瘢痕，溃疡外周红色斑块颜色逐渐变暗、消退。5例非溃疡型血管瘤患儿中4例疗效较好，另1例为多发性血管瘤患儿，B超示其肝脏10余个零星占位，服药1个月后复查B超示肝脏占位减少、缩小，2个月后完全消失，躯干及外阴皮损部位颜色明显变暗，但2个月后服药时有不规律，4个月后自行停药。患儿服药期间定期的血常规、血糖、血压、心功能和肝肾功能检查均未发现明显异常。结论：口服盐酸普萘洛尔对各类型婴幼儿外阴血管瘤均有明确疗效。 |
| 关键词: 口服 盐酸普萘洛尔 婴幼儿 血管瘤 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.01.005 |
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| 基金项目: |
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| Propranolol for Vulvo-perianal Infantile Hemangiomas |
| Chen Xilan, Qian Qiufang |
| (Children’s Hospital of Shanghai Jiao Tong University, Shanghai 200040, China)) |
| Abstract: |
| Objective: To study the efficacy of propranolol for the treatment of perianal infantile hemangiomas (IHs). Methods: 7 children presenting perianal IH were divided into 2 groups by with (group 1) or without (group 2) ulcer. All patients received treatment with oral propranolol started at 0.5 mg/kg-1·day-1 with an increase by 0.5 mg/kg-1·day-1 everyday at the first 3 days, up to 1.5 mg/kg-1·day-1, with the maximum dosees of 2 mg/kg-1·day-1. Complete blood tests and doppler ultrasound were obtained before, during and after treatment. The sizes of the lesion were used to compare. Results: The IH size decreased in all patients. After 1 month of propranolol, 2 patients with ulcer (group 1) healing, with scars instead. After half a year, subcutaneous lesion of group 1 patients cannot be touch. One of group 2 patients was multiple lesions with liver infiltration. After one month of propranolol, the sizes and amounts of liver hemangiomas decreased and declined. After 2 months, all liver hemangiomas disappeared, however this patients lost after 4 months. Other 4 of 5 group 2 patients, all had significant regression of the lesion size of their IH, but releasing pink patching lesion. Two patients were drug discontinuance, with other 2 were releasing doses. Blood tests and ECG were normal before and after oral propranolol. Conclusions: Propranolol has an effective modality of treatment for perianal IH. It seems to be both efficacious for IH with or without ulcer, and solitary or multiple. |
| Key words: Oral Propranolol Infantile Hemangiomas |
