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[婴儿血管瘤:临床及人口统计学特征、治疗经验]

[Infantile haemangioma: clinical and demographic characteristics, experiences in the treatment].

作者信息

Csoma Zsanett Renáta, Dalmády Szandra, Ábrahám Rita, Rózsa Tamás, Rácz Katalin, Kemény Lajos

机构信息

Bőrgyógyászati és Allergológiai Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 6., 6720.

Gyermekgyógyászati Klinika és Gyermekegészségügyi Központ, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged.

出版信息

Orv Hetil. 2017 Oct;158(39):1535-1544. doi: 10.1556/650.2017.30838.

Abstract

INTRODUCTION

Infantile haemangiomas are the most common vascular tumours of infancy. The vast majority of the lesions do not require dermatological treatment due to their unique clinical course and the high rate of spontaneous regression. Approximately 10-15% of the tumours result in severe complications and sequale, requiring special management and close follow-up.

AIM

The aim of the present study was to assess the data of the patients treated with infantile haemangiomas, and to summarize the results of the therapy during 4.5 years of study period, in the Paediatric Dermatology Outpatient Clinic of the Department of Dermatology and Allergology, at the University of Szeged.

METHOD

Demographic data of the infants (gender, gestational age and weight, perinatal history of the infant and medical history of mothers), exact date of the visits at Paediatric Dermatology Outpatient Clinic and tumour characteristics (number, subtype, anatomical localisation and complications) were analysed in details. Treatment modalities and therapy intervals, outcomes and the adverse events of the therapies were also discussed in the survey.

RESULTS

During the study period, 96 infants with 163 infantile haemangiomas were observed. 54 patients required regular observations, while 42 infants required local or systemic beta-blocker therapy. All of the tumours treated with local or systemic therapy showed marked clinical regression; adverse effects were observed in only 6 cases. The gestational age and gestational weight of infants requiring beta-blocker therapy was significantly lower as compared to children needed only observation.

CONCLUSIONS

Systemic propranolol is currently the first-line treatment modality for complicated infantile haemangiomas. Our results confirm the significant therapeutic efficacy of propranolol. Early introduction of the treatment is relevant; unfortunately a great proportion of patients are referred late to Paediatric Dermatology Centres. Orv Hetil. 2017; 158(39): 1535-1544.

摘要

引言

婴儿血管瘤是婴儿期最常见的血管肿瘤。由于其独特的临床病程和较高的自发消退率,绝大多数病变不需要皮肤科治疗。约10%-15%的肿瘤会导致严重并发症和后遗症,需要特殊管理和密切随访。

目的

本研究的目的是评估在塞格德大学皮肤病与变态反应学系儿科皮肤病门诊接受婴儿血管瘤治疗的患者数据,并总结4.5年研究期间的治疗结果。

方法

详细分析婴儿的人口统计学数据(性别、胎龄和体重、婴儿围产期病史和母亲病史)、在儿科皮肤病门诊就诊的准确日期以及肿瘤特征(数量、亚型、解剖定位和并发症)。调查中还讨论了治疗方式和治疗间隔、治疗结果及治疗的不良事件。

结果

研究期间,观察了96例患有163个婴儿血管瘤的婴儿。54例患者需要定期观察,而42例婴儿需要局部或全身β受体阻滞剂治疗。所有接受局部或全身治疗的肿瘤均显示出明显的临床消退;仅6例观察到不良反应。与仅需观察的儿童相比,需要β受体阻滞剂治疗的婴儿的胎龄和出生体重显著更低。

结论

全身性普萘洛尔目前是复杂性婴儿血管瘤的一线治疗方式。我们的结果证实了普萘洛尔显著的治疗效果。尽早开始治疗很重要;不幸的是,很大一部分患者很晚才被转诊至儿科皮肤病中心。《匈牙利医学周报》2017年;158(39): 1535-1544。

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