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普萘洛尔联合595脉冲染料激光 治疗婴幼儿皮肤真性血管瘤76例临床分析
作者:白艳玲1 邹凌云2 顾菲3 
单位:1本溪市金山医院皮肤科 辽宁 本溪 117000 2北京新世纪儿童医院皮肤科  3首都儿研所附属儿童医院皮肤科 
关键词:普萘洛尔 脉冲染料激光 婴幼儿血管瘤 
分类号:R 7322
出版年,卷(期):页码:2018,35(1):6-7
摘要:

 摘要:目的探讨口服普萘洛尔治疗婴幼儿皮肤真性血管瘤停药后,再应用595脉冲染料激光治疗的临床疗效。方法对2013年7月至2015年6月期间首都儿研所附属儿童医院皮肤科门诊就诊的239例皮肤真性血管瘤患儿给予口服普萘洛尔治疗。剂量为第1天05 mg/kg,第2天1 mg/kg,第3天及以后2~3 mg/kg,疗程为5~13个月,平均7个月,停药的平均年龄为28个月。治疗结束停药后,局部仍有瘤体残留的76例患儿皮损部位再序列接受美中互利公司生产的Vbeam 595 nm脉冲染料激光治疗,治疗4~6次,间隔4~6周,随访6个月,观察其疗效及并发症。结果本组76例患儿疗效良好,序列接受激光治疗后,局部遗留的瘤体均有明显消退,局部外观明显改善,达到治愈标准;4例出现水疱、破溃、结痂,1周后愈合,无瘢痕遗留。1例由于搔抓出现局部感染,2周后愈合。2例出现色素脱失,1例出现色素沉着,随访6个月后均自行恢复。1例局部皮肤纹理改变,随访6个月后较前有所改善。结论对口服普萘洛尔停药后仍有瘤体残留的血管瘤患儿,应用染料激光治疗,血管瘤快速消退,遗留痕迹轻或无,不良反应少,疗效确定且安全,患儿家属满意度高。关键词:普萘洛尔;脉冲染料激光;婴幼儿血管瘤

 Abstract:ObjectiveTo investigate the effect of 595 nm pulsed dye laser(PDL)on infantile hemangioma after propranolol treatment Methods239 cases of skin hemangioma were treated with oral propranolol treatment The dose was 05mg/kg on  the first day,1 mg/kg on the second day,2~3 mg/kg on the third day and 3 days laterThe course of treatment was from 5 to 13 months,with an average of 7 months,the average age of withdrawal was about 28 months All the patients were from the department of dermatology of Children's Hospital Affiliated to Capital Institute of Pediatrics from July 2013 to June 2015By the end of treatment after propranolol,there were still 76 cases of local residual tumor were received 595 nm PDL of Chindex international,Incfor 4~6 times with interval of 4~6 weeksAfter 6 months of follow\|up,curative effect and complications were observed Results76 infantile cases obtained excellent effect,the residual hemangiomas were decreased after PDL treatment,local appearance were improved significantly,reaching the standard of cureTemporary side effects included blisters,ulceration,crusting in 4 cases(526%)had healed after 1 weeks,and had no scar Local infection due to scratching in 1 cases(132%)had healed after 2 weeks Hyper\|pigmentation in 1 cases(132%),hypo\|pigmentation in 2 cases(263%),they all disappeared after 6 months Local skin texture had some changed in 1 case(132%)and improved after follow\|up for 6 months ConclusionPDL is effective in the treatment of residual hemangiomas after propranolol treatment Its adverse reactions are less,the effect of therapy is safe and high\|performance,with satisfaction of family membersKey Words:Propranolol;Pulsed dye laser;Infantile hemangioma

 
基金项目:
作者简介:
参考文献:

 参考文献\[1\]金云波,林晓曦,叶肖肖,等普萘洛尔作为严重婴幼儿血管瘤一线治疗的前瞻性研究\[J\]中华整形外科杂志,2011,27(3):170\|173

\[2\]Holmes WJ,Mishra A,Gorst C,et alPropranolol as first line treatment for rapidly proliferating infantile haemangiomas\[J\]J Plast Reconstr Aesthet Surg,2011,64(4):445\|451
\[3\]Schiestl C,Neuhaus K,Zoller SEfficacy and safety of propranolol as first line treatment for infantile hemangiomas\[J\]Eur J Pediatr,2011,170(4):493\|501
\[4\]KK Chik,CK LukUse of propranolol in infantile haemangioma among Chinese children\[J\]Hong Kong Med J,2010,16:341\|346
\[5\]叶肖肖,林晓曦,金云波婴幼儿血管瘤的普萘洛尔治疗\[J\]中国整形外科杂志,2011,27(3):235\|237
\[6\]魏丰贤,阎于珂,魏振刚,等β受体阻滞剂治疗婴幼儿血管瘤有效率和安全性的系统评价和Meta分析\[J\]中国循证儿科杂志,2014,9(6):416\|422
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