邱建文 李健 邹前健 吴龙茂 罗兰 黄亮 李伟俊

[摘要] 目的 探讨口服普萘洛尔治疗婴幼儿头面部血管瘤的临床疗效及安全性。 方法 选择我院皮肤科2019年5月至2020年5月收治的50例头面部血管瘤婴幼儿作为研究对象，根据随机数字表法将其分为A组（n=25）和B组（n=25），其中A组患儿口服普萘洛尔1 mg/（kg·d），B組患儿口服普萘洛尔2 mg/（kg·d），疗程6个月或满足停药标准后停药，采用Achauer 4级评分法评估两组治疗效果，比较两组治疗期间不良反应发生情况，比较两组停药时间、瘤体厚度。 结果 B组患儿治疗总有效率高于A组，差异有统计学意义（P<0.05）。两组不良反应总发生率比较，差异无统计学意义（P>0.05）。B组患儿治疗持续时间短于A组，差异有统计学意义（P<0.05）。B组治疗后瘤体最大厚度低于A组，差异有统计学意义（P<0.05）。 结论 剂量为2 mg/（kg·d）的普萘洛尔治疗婴幼儿头面部血管瘤能够提高治疗效果，缩短治疗时间，用药安全性高。

[关键词] 普萘洛尔;婴幼儿;血管瘤;头面部

[中图分类号] R739.8          [文献标识码] B          [文章编号] 1673-9701（2021）33-0074-03

[Abstract] Objective To explore the clinical efficacy and safety of oral propranolol in the treatment of infantile hemangioma on head and face. Methods A total of 50 infants with head and face hemangioma treated in the Dermatology Department of our hospital from May 2019 to May 2020 were selected as the research objects， and they were divided into group A （n=25） and group B （n=25） according to the random number table method. The patients in group A were given propranolol at 1 mg/（kg·d） orally， while those in group B were given propranolol orally at 2 mg/（kg·d）. The treatment was stopped after 6 months of treatment or after meeting the criteria of drug withdrawal. The therapeutic effects of the two groups were evaluated by Achauer′s grade scale. The adverse reactions of the two groups during treatment were compared， and the time of drug withdrawal and the thickness of the tumor were compared between the two groups. Results The total effective rate of group B was higher than that of group A， and the difference was statistically significant （P<0.05）. The incidence of adverse reactions was 16.00% in group A and 20.00% in group B， with no significant difference between the two groups（P>0.05）. The treatment time in group B was shorter than that in group A， with statistically significant difference（P<0.05）. After treatment， the maximum thickness of tumor in group B was smaller than that in group A， with statistically significant difference（P<0.05）. Conclusion Propranolol at a dose of 2 mg/（kg·d） can improve the treatment effect， shorten the treatment time and have high medication safety in the treatment of infantile hemangioma on head and face.

[Key words] Propranolol; Infants; Hemangioma; Head and face

婴幼儿血管瘤是一种最常见的儿童体表软组织先天性良性肿瘤，数据显示其在婴幼儿群体中发病率为5%～10%，其中约60%的病例发生于机体头面部，对外观及面部功能产生一定影响。相关研究显示[1]，当血管瘤生长在声门、脑部等部位时可造成极大危害，影响生长发育甚至危及生命。目前治疗婴幼儿头面部血管瘤的主要方法有介入栓塞、硬化剂、激光、手术切除、口服药物等。早期研究发现，普萘洛尔用于治疗婴幼儿血管瘤效果显著[2]，但临床使用剂量尚没有明确标准，本研究通过收治50例婴幼儿头面部血管瘤，给予不同剂量普萘洛尔治疗而观察其疗效及疗程，明确普萘洛尔治疗婴幼儿头面部血管瘤的有效性和安全性，现报道如下。……