Department of Medicine, CHU, Montreal, Canada.
J Cutan Med Surg. 2012 Sep-Oct;16(5):317-23. doi: 10.1177/120347541201600508.
Propranolol, a nonselective β-blocker, has been reported as efficient for controlling the growth of complicated infantile hemangiomas (IHs). No uniformly accepted protocol exists regarding the administration of oral propranolol for IH.
We sought to share our experience using propranolol for problematic IH and to evaluate the efficacy of this treatment modality.
A retrospective chart review analysis was performed for 35 consecutive children treated with propranolol as an oral solution on an outpatient basis in our dermatology/vascular anomalies clinic. A protocol was established with the help of our pediatric cardiologists, including pretreatment electrocardiography and echocardiography. Medical photographs taken after 2 months of treatment were rated by two independent evaluators.
We treated 31 girls and 4 boys with a median age of 3.5 months. Rapid improvement was reported in the first days of treatment in 34 patients. Mean improvement after 2 months was 61.5%. No serious adverse effects were reported.
Propranolol was effective in controlling the proliferative phase of problematic IH. It was well tolerated in our study. Outpatient treatment is possible if parents follow strict guidelines. Propranolol should be a first-line treatment for problematic IH in carefully selected patients.
普萘洛尔是一种非选择性β受体阻滞剂，已被报道对控制复杂婴幼儿血管瘤（IH）的生长有效。关于口服普萘洛尔治疗 IH，尚无统一接受的方案。
我们旨在分享我们使用普萘洛尔治疗有问题的 IH 的经验，并评估这种治疗方式的疗效。
对在我们皮肤科/血管异常诊所接受口服普萘洛尔治疗的 35 名连续儿童进行回顾性图表审查分析。在我们儿科心脏病专家的帮助下制定了方案，包括治疗前心电图和超声心动图。治疗 2 个月后拍摄的医学照片由两名独立评估者进行评分。
我们治疗了 31 名女孩和 4 名男孩，中位年龄为 3.5 个月。34 名患者在治疗的最初几天报告了快速改善。2 个月后的平均改善率为 61.5%。未报告严重不良事件。
普萘洛尔可有效控制有问题的 IH 的增殖期。在我们的研究中，它具有良好的耐受性。如果家长严格遵循指南，门诊治疗是可行的。普萘洛尔应成为精心挑选的患者有问题的 IH 的一线治疗药物。
