普萘洛尔治疗23例婴幼儿腮腺深部血管瘤效果评价

中国口腔颌面外科杂志 ›› 2015, Vol. 13 ›› Issue (6): 530-533.

普萘洛尔治疗23例婴幼儿腮腺深部血管瘤效果评价

司亚萌，孟箭，张兴，张爱侠，郑浩，魏景健

徐州市中心医院?潍坊医学院徐州口腔临床学院口腔颌面外科，江苏徐州 221000

收稿日期:2015-05-05 出版日期:2015-11-20 发布日期:2015-12-03
通讯作者: 孟箭，E-mail:mrocket@163.com
作者简介:司亚萌(1975–)，男，硕士，副主任医师，E-mail:18905200972@189.cn
基金资助:
Supported by Science and Technology Project of the Fourth “333 Engineering" of Jiangsu Province (BRA2015069), and Science and Technology Project of Clinical Medicine of Jiangsu Province (BL2013008).

Propranolol treatment for deep infantile hemangiomas on the parotid area: a report of 23 cases

SI Ya-meng, MENG Jian, ZHANG Xing, ZHANG Ai-xia, ZHENG Hao, WEI Jing-jian.

Department of Oral and Maxillofacial Surgery, Xuzhou Central Hospital, Clinical Hospital of Weifang Medical College. Xuzhou 221000, Jiangsu Province, China

Received:2015-05-05 Online:2015-11-20 Published:2015-12-03
Contact: 江苏省第四期“333工程”科研项目（BRA‘2015069）；江苏省科技厅临床医学科技专项(BL2013008)

摘要/Abstract

摘要： 目的：评价小剂量普萘洛尔治疗婴幼儿腮腺深部血管瘤的临床疗效和安全性。方法：23例婴幼儿腮腺深部血管瘤患者，按1.0~1.5 mg/kg剂量口服普萘洛尔，每天3次，连续服药6~10个月。每个月1次动态观察和记录血管瘤颜色、质地变化，并行彩超检查，观察大小变化，随时处理治疗过程中出现的不良反应。按4级评分法对近期疗效进行评价。结果：23例患儿平均口服普萘洛尔7.8个月，疗效：I级0例，Ⅱ级：1例，Ⅲ级：4例，IV级：18例。均未发生严重不良反应。3例复发，再次服用普萘洛尔后仍有效。结论：口服小剂量普萘洛尔治疗婴幼儿腮腺深部血管瘤近期疗效良好，不良反应轻微，同时对复发病例仍有效，但治疗时间尚需进一步研究。

关键词: 深部血管瘤, 腮腺, 普萘洛尔

Abstract: PURPOSE : To evaluate the efficacy and safety of propranolol for the treatment of deep infantile hemangiomas(IH) on the parotid area. METHODS : Oral propranolol at a dose of 1.0-1.5 mg/kg three times per day was administered to 23 deep parotid IHs.The duration of treatment ranged from 6 to 10 months. The changes of the tumor colour and texture were monitored and recorded at a regular interval. At the same time, size was documented by ultrasound echo color doppler. The adverse effects after medication were observed and managed accordingly. To assess the efficacy, a 4 scales system was adopted. RESULTS : The average propranolol treatment duration for the 23 patients was 7.8 months, the overall response was slight in 0 patient，moderate in 1 patients, good in 4 patients，and excellent in 18 patients. No serious adverse events were encountered.A second course of propranolol readily controlled the rebound growth of deep IH in 3 patients(13%). CONCLUSIONS : Propranolol yielded excellent results with very good clinical tolerance and also seems to be effective for IH rebound growth. The optimal duration of the treatment remains to be defined by long-term observation.

Key words: Deep infantile hemangiomas, Parotid gland, Propranolol

中图分类号:

R739.8

司亚萌，孟箭，张兴，张爱侠，郑浩，魏景健. 普萘洛尔治疗23例婴幼儿腮腺深部血管瘤效果评价[J]. 中国口腔颌面外科杂志, 2015, 13(6): 530-533.

SI Ya-meng, MENG Jian, ZHANG Xing, ZHANG Ai-xia, ZHENG Hao, WEI Jing-jian.. Propranolol treatment for deep infantile hemangiomas on the parotid area: a report of 23 cases[J]. China J Oral Maxillofac Surg, 2015, 13(6): 530-533.

参考文献

[1] Phung TL, Hochman M, Mihm MC, et al. Current knowledge of the pathogenesis of infantile hemangiomas [J]. Arch Facial Plast Surg, 2005, 7(5): 319-321.
[2] Saint-Jean M, Léauté-Labrèze C, Mazereeuw-Hautier J, et al. Propranolol for treatment of ulcerated infantile hemangiomas [J]. J Am Acad Dermatol, 2011, 64(5): 827-832.
[3] Achauer BM, Chang CJ, Vander Kam VM. Management of hemangioma of infancy: review of 245 patients [J]. Plast Reconstr Surg, 1997, 99(5): 1301-1308.
[4] Waner M, Suen JY. Management of congenital vascular lesions of the head and neck [J]. Oncology(Williston Park), 1995, 9(10): 989-994, 997.
[5] 麦华明, 郑家伟, 张凌, 等. 普萘洛尔对血管瘤中HemSC凋亡和VEGF、bFGF表达的影响及临床意义 [J]. 中国口腔颌面外科杂志, 2013, 11(4): 287-296.
[6] Léauté-Labrèze C, Dumas de la Roque E, Hubiche T, et al. Propranolol for severe hemangiomas of infancy [J]. N Engl J Med, 2008, 358(24): 2649-2651.
[7] Marqueling AL, Oza V, Frieden IJ, et al. Propranolol and infantile hemangiomas four years later: a systematic review [J]. Pediatr Dermatol, 2013, 30(2): 182-191.
[8] Weiss I, O TM, Lipari BA, et al. Current treatment of parotid hemangiomas [J]. Laryngoscope, 2011, 121(8): 1642-1650.
[9] Georgountzou A, Karavitakis E, Klimentopoulou A, et al. Propranolol treatment for severe infantile hemangiomas: a single-centre 3-year experience [J]. Acta Paediatr, 2012, 101(10): 469-474.
[10] Neri I, Balestri R, Patrizi A. Hemangiomas: new insight and medical treatment [J]. Dermatol Ther, 2012, 25(4): 322-334.
[11] Giachetti A, Garcia-Monaco R, Sojo M, et al. Long-term treatment with oral propranolol reduces relapses of infantile hemangiomas [J]. Pediatr Dermatol, 2014, 31(1): 14-20.
[12] Lynch M, Lenane P, O'Donnell BF. Propranolol for the treatment of infantile haemangiomas:
our experience with 44 patients [J]. Clin Exp Dermatol, 2014, 39(2): 142-145.
[13] Storch CH, Hoeger PH. Propranolol for infantile haemangiomas: insights into the molecular mechanisms [J]. Br J Dermatol, 2010, 163(2): 269-274.

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