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目的 :评价普萘洛尔治疗溃疡性婴幼儿血管瘤的临床疗效和安全性。方法 :选择2009年6月—2015年10月于中国医科大学附属口腔医院收治的18例并发溃疡的婴幼儿血管瘤患者,其中男7例,女11例。所有患儿均口服普萘洛尔,按1.0~1.5 mg/kg给药,每天1次顿服,连续给药3~12个月。每周复诊,至溃疡面完全愈合后改为每月复诊。动态观察并记录血管瘤大小、质地和颜色变化,溃疡面愈合情况、愈合时间,治疗结束或瘤体消退后有无瘢痕遗留。通过治疗期间出现的不良反应进行安全性评价。结果:18例患儿溃疡愈合时间为2~9周,平均3.96周;治疗时间为3~12个月,平均8个月;随诊时间8~24个月,平均17.8个月。2例患者遗留瘢痕。发现心率减慢、腹泻、溢奶、睡眠改变等不良反应,均未做特殊处理,未发生严重全身或局部不良反应。结论:口服普萘洛尔治疗溃疡性婴幼儿血管瘤能使溃疡面在短期内愈合,使血管瘤明显缩小,不良反应轻微,可作为治疗溃疡性婴幼儿血管瘤的首选方法。
Objective: To evaluate the clinical efficacy and safety of propranolol in the treatment of ulcerative infantile hemangiomas. Methods: Totally 18 infantile hemangiomas with ulceration were selected from the Department of Stomatology, China Medical University from June 2009 to October 2015, including 7 males and 11 females. All children were given propranolol orally, according to 1.0 ~ 1.5 mg / kg, day 1 Dayton clothing, continuous administration of 3 to 12 months. Weekly referral to the ulcer surface completely changed to a monthly referral. Dynamic observation and record of hemangioma size, texture and color changes, ulcer surface healing, healing time, the end of treatment or tumor regression with or without scarring. Safety evaluations were performed through adverse reactions during treatment. Results: The healing time of ulcer in 18 cases was 2 to 9 weeks (average 3.96 weeks). The treatment time ranged from 3 to 12 months with an average of 8 months. The follow-up time ranged from 8 to 24 months (mean, 17.8 months). Two patients left scar. Found that slow heart rate, diarrhea, overflowing milk, sleep changes and other adverse reactions, did not make special treatment, no serious systemic or local adverse reactions. Conclusion: Oral administration of propranolol in the treatment of ulcerated infantile hemangiomas can heal the ulcer surface in a short period of time, reduce the hemangiomas significantly, and have mild adverse reactions. It can be used as the first choice for the treatment of ulcerative infantile hemangiomas.