“阶梯治疗方案”口服普萘洛尔治疗婴幼儿混合型和深层血管瘤的疗效评价

发布时间：2018-03-26 06:37

  本文选题：阶梯治疗方案　切入点：普萘洛尔　出处：《吉林大学学报(医学版)》2017年04期

【摘要】：目的:采用"阶梯治疗方案"口服普萘洛尔治疗婴幼儿混合型和深层血管瘤,探讨其疗效及安全性。方法:治疗前对98例婴幼儿混合型和深层血管瘤患儿进行全面评估,并行心电图、心脏彩超、血糖、肝功能、肾功能、心肌酶和血常规检查,排除禁忌证后均给予"阶梯治疗方案"口服普萘洛尔治疗,剂量从0.5mg·kg-1·d-1逐渐增加至4.0mg·kg-1·d-1,分3次口服,服药前和服药后1和2h监测心率,动态观察瘤体大小、质地、颜色等变化及患儿有无相关不良反应,每个月复诊,按4级评分法进行疗效评价。结果:服药后,98例患儿瘤体均出现不同程度颜色变浅或质地变软,普茶洛尔剂量增至4.0mg·kg-1·d-1后瘤体性质变化最快。疗效评价,Ⅳ级(优)84例(85.71%),Ⅲ级(好)2例(2.04%),Ⅱ级(中)4例(4.08%),Ⅰ级(差)8例(8.16%)。混合型血管瘤的疗效优于深层血管瘤(P0.05)。74例血管瘤患儿痊愈时间为6个月。主要不良反应,心率下降5例(5/98,5.10%),嗜睡3例(3/98,3.06%),腹泻7例(7/98,7.14%),食欲不振1例(1/98,1.02%),抽搐2例(2/98,2.04%),给予对症处理后均恢复正常。停药后2个月复发4例,继续服药仍然有效。结论:"阶梯治疗方案"口服普萘洛尔治疗婴幼儿混合型和深层血管瘤疗效明显,且无严重不良反应发生。
[Abstract]:Objective: to evaluate the efficacy and safety of oral propranolol in the treatment of mixed and deep hemangioma in infants. Methods: 98 cases of infantile mixed and deep hemangioma were evaluated before treatment. Electrocardiogram, color Doppler echocardiography, blood glucose, liver function, renal function, myocardial enzyme and blood routine examination were performed. After removing contraindications, propranolol was given orally to 0.5mg kg-1 d-1, and the dosage was gradually increased from 0.5mg kg-1 d-1 to 4.0mg kg-1 d-1. Heart rate was monitored before and 1 and 2 hours after taking the drug. The changes of tumor size, texture and color were observed dynamically. Results: all the 98 children's tumors showed light color or soft texture in varying degrees after taking the medicine, and the nature of the tumor changed most quickly when the dosage of prochlorolol was increased to 4.0mg kg-1 d-1, and the curative effect was evaluated. Grade 鈪，

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