Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Dermatol. 2019 May;46(5):376-382. doi: 10.1111/1346-8138.14853. Epub 2019 Mar 27.
Infantile hemangiomas (IH) undergo rapid growth during early infancy followed by gradual involution. After involution, a part of IH remain as residual lesions. Since 2008, oral propranolol has been widely used in the treatment of IH. However, long-term outcome of IH treated with propranolol remains unknown. This study aimed to investigate the sequelae of IH treated with propranolol. In this study, propranolol was given at a dose of 2 mg/kg per day at the age of 3.8 ± 2.5 months and follow-up visits were arranged to continue at least through the age of 4 years. Types of sequela were recorded and classified as four degrees ("none", "minimal", "significant" and "severe" at last visit), then subsequent therapy was evaluated with the help of magnetic resonance imaging (MRI). A total of 73 patients with complete follow up were enrolled in the study. The most common types of sequela were telangiectasia, fibrofatty tissue and erythema. Significant and severe sequelae were observed in 72.4% of treated IH; superficial IH led to more but not significantly significant and severe sequelae than mixed IH (P > 0.05). Despite propranolol treatment, surgery was still needed in 37.5% of IH at a mean age of 70.3 months, and for the main reason of surgery, fibrofatty or hemangioma residua, MRI was useful for us to choose an appropriate surgical procedure.
婴幼儿血管瘤(IH)在婴儿早期经历快速生长,随后逐渐消退。消退后,一部分 IH 仍留有残余病变。自 2008 年以来,口服普萘洛尔已广泛用于 IH 的治疗。然而,普萘洛尔治疗 IH 的长期结果尚不清楚。本研究旨在探讨普萘洛尔治疗 IH 的后遗症。在这项研究中,普萘洛尔的剂量为 2mg/kg/天,在 3.8±2.5 个月时开始服用,并安排随访,至少持续到 4 岁。记录了后遗症的类型,并分为四级(最后一次就诊时为“无”、“轻微”、“显著”和“严重”),然后在磁共振成像(MRI)的帮助下评估后续治疗。共有 73 例完全随访的患者纳入研究。最常见的后遗症类型是毛细血管扩张、纤维脂肪组织和红斑。接受治疗的 IH 中 72.4%存在显著和严重的后遗症;与混合 IH 相比,单纯 IH 导致更多但无统计学显著的显著和严重后遗症(P>0.05)。尽管进行了普萘洛尔治疗,但仍有 37.5%的 IH 在平均 70.3 个月大时需要手术,手术的主要原因是纤维脂肪或血管瘤残余物,MRI 有助于我们选择合适的手术方式。