Fei Qiang, Lin Yu, Chen Xian
Department of Pediatrics, The Children's Hospital of Zhejiang University School of Medicine, No.3333, Binsheng Rd, Hangzhou 310003, China.
EClinicalMedicine. 2020 Aug 18;26:100506. doi: 10.1016/j.eclinm.2020.100506. eCollection 2020 Sep.
Infantile hemangioma (IH) is common in children, which may bring about cosmetically disfiguring, functional impairment, and exhibiting complications. There had been various therapies and we aimed to assess the efficacy and adverse effects of different therapies through network meta-analysis.
We searched PubMed, Embase, Cochrane Library and Web of Science (from database inception to April 11, 2020) for studies assessing the efficacy, success rate and adverse effects. Direct pairwise comparison and a network meta-analysis under random effects were performed. We also assessed the ranking probability.
A total of 30 randomized clinical trials with more than 20 different therapeutic regimens were identified. Treatment combined propranolol orally with laser could improve the curative effect than monotherapy. Laser with topical β blockers showed more efficiency than others whether in children under 6 months or not. The long-pulsed dye laser might be the best laser therapy. A higher dose and a longer treatment duration of propranolol orally achieved a higher success rate and increased side effects. Plus pulse dye laser with propranolol had the lowest incidence of adverse reactions, such as ulcer, color sink and color reduction.
A combination of β blockers and laser might be the first-line treatment of IHs and a longer pulsed dye laser is preferred.
No funding was received.
婴儿血管瘤（IH）在儿童中很常见，可能会导致容貌毁损、功能障碍并出现并发症。已有多种治疗方法，我们旨在通过网络荟萃分析评估不同治疗方法的疗效和不良反应。
我们检索了PubMed、Embase、Cochrane图书馆和Web of Science（从数据库建立至2020年4月11日），以查找评估疗效、成功率和不良反应的研究。进行了直接成对比较和随机效应下的网络荟萃分析。我们还评估了排序概率。
共确定了30项随机临床试验，涉及20多种不同的治疗方案。口服普萘洛尔联合激光治疗比单一疗法能提高疗效。无论患儿是否小于6个月，激光联合局部β受体阻滞剂治疗比其他疗法更有效。长脉冲染料激光可能是最佳的激光治疗方法。口服普萘洛尔剂量越高、治疗时间越长，成功率越高，但副作用增加。此外，普萘洛尔联合脉冲染料激光的不良反应发生率最低，如溃疡、色素沉着和色素减退。
β受体阻滞剂和激光联合治疗可能是婴儿血管瘤的一线治疗方法，首选较长脉冲的染料激光。
未获得资金。
