普萘洛尔联合脉冲染料激光治疗婴幼儿血管瘤疗效观察.docVIP

普萘洛尔联合脉冲染料激光治疗婴幼儿血管瘤疗效观察 　　[摘要]目的：评估普萘洛尔联合脉冲染料激光治疗婴幼儿血管瘤的疗效。方法：将24例婴幼儿血管瘤初诊患者随机分成两组。治疗组：采用脉冲染料激光联合口服普萘洛尔药物治疗，激光间隔30d重复治疗，直至皮损完全消退。统计激光治疗次数和并发症情况；对照组：单纯采用脉冲染料激光治疗，间隔30d重复治疗，直至皮损消退，统计激光治疗次数和并发症。结果：治疗组激光治疗次数明显少于对照组，并发症发生率亦明显少于对照组。结论：普萘洛尔联合脉冲染料激光治疗婴幼儿血管瘤疗效明显，有很好的临床应用前景。 　　[关键词]婴幼儿血管瘤；普萘洛尔；脉冲染料激光 　　[中图分类号]R732.2 [文献标志码]A [文章编号]1008-6455（2015）14-0043-02 　　Abstract： Objective To evaluate the outcome of propranolol combined pulsed dye laser treatment of infantile hemangiomas. Methods 24 cases of infantile hemangiomas patients were randomly divided into two groups.The treatment group received pulsed dye laser therapy combined with oral propranolol therapy.The treatment group use oral propranolol at the first one month，then combine pulsed dye laser therapy.Laser treatment was repeated monthly intervals，until the lesions disappeared completely.The control group received pulse dye laser therapy each month only.For both groups，the number of laser treatment and complications were recorded. Results The number of laser treatment significantly was less in treatment group than control group，and the incidence of complications were significantly less too. Conclusion Based on the results of this study，the effect of oral propranolol combined pulsed dye laser treatment of infantile hemangiomas is obvious.It has a good clinical application prospects. 　　Key words：infantile hemangiomas；Propranolol；Pulsed dye laser 　　婴幼儿血管瘤（Infantile Hemangiomas，IH），是婴幼儿最常见的良性肿瘤，系以血管内皮细胞增殖为特征的胚胎性良性肿瘤。好发于头、面、颈部，其次为四肢和躯干。新生儿发生率为1.1%～2.6%，男女比率1∶2～5[1]。位于头面部者可影响容貌， 严重者可因压迫邻近器官而影响视力和呼吸等，故常需早期干预治疗[2]。治疗方法有口服或瘤体内注射激素、硬化剂治疗、激光及手术等，均有一定缺点[3]。2008年，法国Bordeaux儿童医院leaute-labreze等首次报道了普萘洛尔对婴幼儿血管瘤有良好疗效，这一发现在医学界产生了巨大的影响，引起国际上应用普洛萘尔治疗血管瘤的研究热潮，2011年8月-2012年8月，笔者科室对婴幼儿血管瘤患儿采用普萘洛尔联合脉冲染料激光治疗，效果显著，现报道如下。 　　1 资料和方法 　　1.1 临床资料 　　婴幼儿血管瘤24例，其中男6例，女18例，年龄1～3个月，平均为1.8个月，均为初诊患者，未接受任何治疗，将病例随机分成治疗组和对照组，每组各12例。治疗组采用脉冲染料激光联合口服普萘洛尔药物治疗，激光间隔1个月后重复治疗，直至皮损完全消退，药物视情况坚持3～6个月；对照组单纯采用脉冲染料激光治疗，间隔1个月后重复治疗，直至皮损消退。随访12～18个月。 　　1.2 治疗方法