Gałązka Przemysław, Bereźnicka Weronika, Leis Kamil, Kaczor Patryk, Daniluk-Matraś Irena, Czajkowski Rafał, Bolewicz-Planutis Iwona
Department of General and Oncological Surgery for Children and Adolescents, Antoni Jurasz University Hospital No. 1 in Bydgoszcz, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Department of Dermatology and Venerology, Faculty of Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Postepy Dermatol Alergol. 2020 Aug;37(4):603-607. doi: 10.5114/ada.2020.98282. Epub 2020 Sep 2.
Haemangioma, one of the most common benign neoplasms of early childhood, is a significant clinical problem due to cosmetic reasons but also because of possible health complications.
Presentation of the method and results of treatment of infantile haemangiomas (IHs) using propranolol in a maximum dose of 3 mg/kg/day.
In 2013 to 2018 there were 108 patients with IHs multidisciplinary diagnosed and treated. 77 of them were girls and 31 were boys; all were between the ages of 2 and 21 months (mean: 6.87 months). Lesions were most often located in the head region ( = 73). The main imaging study assessing the arteriovenous flow was USG, which was used to assess the size of haemangioma and its regression or progression. Also, coagulation parameters were analysed using laboratory tests.
Reduction of lesions occurred in 103 of 108 patients, which results in a percentage score above 95. In 19 patients, after completion of treatment, there were abnormalities of coagulation in laboratory tests whereas before the treatment, these abnormalities occurred in 82 patients. The average duration of treatment was longer than 12 months and the maximum dose of propranolol of 3 mg/kg/day was achieved after 3 to 5 months of treatment. Side effects occurred totally in 19 patients, with night anxiety and nightmares being the most common.
After achieving the maximum dose of the drug later than recommended in the Recommendation of the Polish Haemangioma and Vascular Malformations Group criteria, there was no need for longer therapy, while the effectiveness of the treatment remained unchanged. Side effects that occurred were not life-threatening or detrimental to the health of patients.
血管瘤是儿童早期最常见的良性肿瘤之一,因其可能导致的美容问题以及潜在的健康并发症,成为一个重要的临床问题。
介绍使用最大剂量为3mg/kg/天的普萘洛尔治疗婴儿血管瘤(IHs)的方法及结果。
2013年至2018年,对108例多学科诊断和治疗的IHs患者进行研究。其中77例为女孩,31例为男孩;年龄均在2至21个月之间(平均6.87个月)。病变最常位于头部区域(n = 73)。评估动静脉血流的主要影像学检查是超声检查(USG),用于评估血管瘤的大小及其消退或进展情况。此外,还通过实验室检查分析凝血参数。
108例患者中有103例病变缩小,百分比得分超过95%。19例患者在治疗结束后实验室检查出现凝血异常,而治疗前有82例出现此类异常。平均治疗持续时间超过12个月,治疗3至5个月后达到普萘洛尔的最大剂量3mg/kg/天。共有19例患者出现副作用,其中夜间焦虑和噩梦最为常见。
在达到波兰血管瘤和血管畸形小组标准建议中比推荐时间更晚的最大药物剂量后,无需延长治疗时间,而治疗效果保持不变。出现的副作用不危及生命,也不对患者健康造成损害。