目的探讨口服普萘洛尔治疗婴幼儿体表血管瘤的临床效果、安全性及方法。方法 2010年1月至2013年1月,口服普萘洛尔治疗56例婴幼儿体表血管瘤,瘤体范围0.8 cm×0.6 cm~4.0 cm×4.5 cm。初始剂量为0.5 mg/Kg·d,分2次餐后服用;若患儿无不良反应,则每日增加0.2 mg/Kg,直至1.5 mg/Kg·d;维持治疗4个月后,每日减少0.2 mg/Kg,逐日减量至停药。治疗期间每月随诊1次。治疗结束半年后参照Achauer标准进行疗效评价。结果 1例患儿服药不到1个月因出现疲劳乏力家属放弃治疗,2例服药3个月后瘤体基本消退而停药,其余53例均维持服药4个月。治疗结束时,大部分血管瘤明显缩小,颜色变淡,甚至消退。停药6个月后评定疗效:Ⅰ级2例(含复发1例),Ⅱ级6例(含复发5例),Ⅲ级17例,Ⅳ级31例,停药后复发6例。服药过程中1例出现明显疲劳乏力,6例出现间隙性腹泻但不影响饮食及治疗,未出现其他不良反应。结论口服普萘洛尔是治疗婴幼儿体表血管瘤的有效方法之一,其治疗效果及安全性可能与剂量及用药方式有关。

Objective To explore the efficacy, safety and appropriate method of oral propranolol for superficial infantile hemangiomas. Methods From January 2010 to January 2013, 56 cases with infantile hemangiomas in superficial body were treated with oral propranolol. These lesions ranged from 0.8 cm ×0.6 cm to 4.0 cm ×4.5 cm. Propranolol was administered orally twice a day after meal. The initial dose was 0.5 mg/Kg·d, and was added 0.2 mg/Kg every day till it added up to 1.5 mg/Kg·d only if complications were not occurred in the cases. After treated for 4 months, the dose was decreased by 0.2 mg/Kg every day to withdrawal. Follow-up was conducted every month during treatment. The response to therapy after 6 months of propranolol withdrawal was evaluated using Achauer system. Results Fifty-three cases took propranolol for 4 months, 1 case gave up therapy because of obvious fatigue during the first month of treatment, and 2 cases ended treatment as they had gotten cured almostly after taking propranolol for 3 months. Most hemangiomas decreased distinctly in size and color, and some even disappeared completely when treatment ended. According to Achauer system, 2 cases were scale Ⅰ(including 1 recurrence), 6 cases were scaleⅡ (including 5 recurrence), 17 cases were scale Ⅲand 31 cases were scaleⅣafter six months of propranolol withdrawal. Recurrence of lesion was noticed in six cases after propranolol withdrawal. No other adverse reaction was observed during taking medication except obvious fatigue in 1 case and intermittent diarrhea without affecting diet and therapy in 6 cases. Conclusion Oral propranolol is one of the effective methods for treating infantile hemangiomas located in superficial body, both the efficacy and safety are probably relative to its dose and usage.