Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, U.K.
Royal Hospital for Children, Glasgow, U.K.
Br J Dermatol. 2018 Sep;179(3):582-589. doi: 10.1111/bjd.16779.
Infantile haemangiomas (IH) are the most common vascular tumours of infancy. Despite their frequency and potential complications, there are currently no unified U.K. guidelines for the treatment of IH with propranolol. There are still uncertainties and diverse opinions regarding indications, pretreatment investigations, its use in PHACES (posterior fossa malformations-haemangiomas-arterial anomalies-cardiac defects-eye abnormalities-sternal cleft and supraumbilical raphe) syndrome and cessation of treatment.
To provide unified guidelines for the treatment of IH with propranolol.
This study used a modified Delphi technique, which involved an international treatment survey, a systematic evidence review of the literature, a face-to-face multidisciplinary panel meeting and anonymous voting.
The expert panel achieved consensus on 47 statements in eight categories, including indications and contraindications for starting propranolol, pretreatment investigations, starting and target dose, monitoring of adverse effects, the use of propranolol in PHACES syndrome and how to stop treatment.
These consensus guidelines will help to standardize and simplify the treatment of IH with oral propranolol across the U.K. and assist in clinical decision-making.
婴儿血管瘤（IH）是婴儿期最常见的血管肿瘤。尽管 IH 很常见且可能会引起并发症，但目前英国尚无关于普萘洛尔治疗 IH 的统一指南。关于适应证、治疗前检查、在 PHACES 综合征（后颅窝畸形-血管瘤-动脉异常-心脏缺损-眼部异常-胸骨裂和脐上嵴）中的应用以及何时停止治疗，仍存在不确定性和不同意见。
为普萘洛尔治疗 IH 提供统一的指南。
本研究采用改良 Delphi 技术，包括国际治疗调查、系统文献复习、面对面多学科小组会议和匿名投票。
专家小组就 8 个类别中的 47 个条目达成共识，包括开始使用普萘洛尔的适应证和禁忌证、治疗前检查、起始和目标剂量、不良反应监测、在 PHACES 综合征中使用普萘洛尔以及如何停止治疗。
这些共识指南将有助于规范和简化英国口服普萘洛尔治疗 IH，并有助于临床决策。
