Przewratil Przemysław, Sitkiewicz Anna, Kierzkowska Beata, Lewandowska Magdalena, Lewandowska Małgorzata, Andrzejowska Ewa
Klinika Chirurgii i Onkologii Dziecięcej UM Łódź, ul. Sporna 36/50, 91-738 Łódź,
Med Wieku Rozwoj. 2011 Jul-Sep;15(3 Pt 2):406-13.
Infantile haemangiomas are the most common vascular tumours in children. Since 2008 the application of propranolol has been a promising therapy in the management of haemangiomas.
Analysis of the patients with infantile haemangiomas treated with propranolol.
Between June 2009 and December 2010 in Department of Pediatric Surgery and Oncology Medical University of Lodz, 35 children with infantile haemangiomas (29 females and 6 males) were treated with propranolol. Therapy was initiated in age of 2-15 months (mean 4.5). All infantile haemangiomas were in a proliferative phase. In 27 children lesions were located in the head and neck, 2 of them were located in the orbital region and 3 penetrated into the orbit. In 5 children haemangiomas were located in the trunk, with 3 in the perineum and 3 in limbs. In 2 children the PHACE Syndrome was diagnosed. In one of these cases exploratory laparatomy revealed jejunal haemangiomatosis. The indication for propranolol application was impairment of physiological functions in 23 cases, cosmetic defect in 8 and ulceration in 4. The duration of treatment was 4 to 12 months (mean 7.5-months). The change of haemangioma volume, density and colour were evaluated. Reduction of ˝ haemangioma volume was assessed as very good response, 1/3 as good response, and 1/4 as poor.
In 7 patients therapy has been finished. In all cases decrease in density, volume and fading was observed. Very good result was achieved in 27 patients, good in 5, poor in 3. Recurrence of haemangioma appeared in two patients after termination of treatment. A spectacularly good result was achieved in the child with PHACE syndrome and in one with jejunal haemangiomatosis.
Propranolol therapy is safe and effective in children with infantile proliferating haemangiomas. It can be the treatment of choice in cases with impairment of physiological functions or severe cosmetic defect. Election and therapy of the children should be carried out in highly reference centres.
婴儿血管瘤是儿童最常见的血管肿瘤。自2008年以来，普萘洛尔的应用已成为血管瘤治疗中一种有前景的疗法。
分析接受普萘洛尔治疗的婴儿血管瘤患者。
2009年6月至2010年12月期间，罗兹医科大学小儿外科和肿瘤科对35例婴儿血管瘤患儿（29例女性，6例男性）进行了普萘洛尔治疗。治疗开始于2至15个月龄（平均4.5个月）。所有婴儿血管瘤均处于增殖期。27例患儿的病变位于头颈部，其中2例位于眼眶区域，3例侵入眼眶。5例患儿的血管瘤位于躯干，3例位于会阴，3例位于四肢。2例患儿被诊断为PHACE综合征。其中1例经剖腹探查发现空肠血管瘤病。普萘洛尔应用的指征为23例生理功能受损、8例美容缺陷和4例溃疡。治疗持续时间为4至12个月（平均7.5个月）。评估血管瘤体积、密度和颜色的变化。血管瘤体积缩小1/2被评估为非常好的反应，缩小1/3为好的反应，缩小1/4为差的反应。
7例患者完成治疗。所有病例均观察到密度、体积降低和褪色。27例患者取得非常好的效果，5例效果良好，3例效果差。2例患者治疗结束后血管瘤复发。PHACE综合征患儿和1例空肠血管瘤病患儿取得了非常好的效果。
普萘洛尔治疗婴儿增殖性血管瘤患儿安全有效。对于生理功能受损或严重美容缺陷的病例，它可以作为首选治疗方法。儿童的选择和治疗应在高度专业的中心进行。
