ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2019, Vol. 11 ›› Issue (6): 516-520.

• 临床研究 • 上一篇    下一篇

普萘洛尔联合平阳霉素硬化治疗婴儿血管瘤疗效及瘤体发生部位和面积的危险因素分析

  

  • 出版日期:2019-12-25 上线日期:2023-12-06

Effect of propranolol combined with pingyangmycin sclerotherapy for infants with hemangioma and the risk factors analysis of tumor location and tumor area

  • Published:2019-12-25 Online:2023-12-06

摘要： 目的研究手术治疗和口服普耐洛尔联合平阳霉素硬化治疗3个月以内婴儿血管瘤的疗效对比,并分析瘤体发生部位和瘤体面积有关的影响因素。方法选取我院2018年4月至2018年10月就诊的所有婴儿血管瘤患儿40例,接受手术治疗和接受药物治疗(口服普萘洛尔+平阳霉素硬化)的患儿各20例。回顾性分析两组患儿接受不同治疗后的临床疗效和不良反应。对可能影响瘤体发生部分和面积的各种危险因素,如儿童出生体质量,母亲妊娠史、年龄、黄体酮使用史、维生素服用是否过量、是否早产、有无胎盘异常和妊娠期高血压,做多因素Logistic回归分析,获得独立危险因素。结果 (1)两组临床总有效率比较差异无统计学意义(P>0.05)。(2)药物组大量出血(>100 mL)和高热(>38℃)方面发生不良反应数低于手术组,差异有统计学意义(P<0.05)。(3)瘤体发生部位的危险因素分析:儿童出生体质量≤2 500 g和母亲孕期黄体酮使用史是血管瘤好发于头颈部的独立危险因素,低出生体重儿和母亲曾孕期使用黄体酮的患儿血管瘤发生于头颈部的概率分别是发生于四肢及其他部位概率的13.698倍和18.744倍。(4)瘤体面积的危险因素分析:母亲多次妊娠史是患儿血管瘤瘤体面积>6 cm2的独立危险因素,母亲有多次妊娠史的患儿发生血管瘤瘤体面积>6 cm2的概率是瘤体面积≤6 cm2概率的17.896倍。结论口服普萘洛尔联合平阳霉素硬化治疗3个月以内婴儿血管瘤效果显著,且不良反应少,值得临床推广,同时早期要筛查患儿母亲的生育及孕期用药信息,对于孕期使用黄体酮,孕周<37周及多次妊娠的孕妇给予及时的干预治疗,以避免婴儿血管瘤的发生发展。 

关键词:

婴儿血管瘤, 普萘洛尔, 平阳霉素, 儿童

Abstract:

ObjectiveTo compare the curative effect of surgical treatment with that of oral propranolol combined with pingyangmycin sclerotherapy in 3-month old infants with hemangioma, and to analyze the influencing factors related to tumor location and tumor area.MethodsForty hemangioma infants treated from April 2018 to October 2018 in our hospital were selected, including 20 patients receiving surgery and 20 receiving medication(oral propranolol+pingyangmycin sclerotherapy). The clinical efficacy and adverse reactions were retrospectively analyzed. Various risk factors potentially affecting tumor location and tumor area, such as child birth weight, pregnancy history, age, progesterone use history, vitamins excess, premature, placental abnormalities, and hypertension during pregnancy, were analyzed by multivariate logistic regression analysis to obtain independent risk factors.Results(1)There was no significant difference in the total effective rate between the two groups(P>0.05). (2)The number of adverse reactions in massive bleeding(>100 mL) and high fever(>38 ℃) in medication group was lower than that in surgery group, and the difference was statistically significant(P<0.05). (3)Analysis of risk factors of tumor location: child birth weight≤2 500 g and progesterone use history were independent risk factors for hemangiomas mainly in head and neck. Hemangioma incidence in head and neck was 13.698 times and 18.744 times that of tumor occuring in limbs and other parts, respectively. (4)Analysis of risk factors of tumor area: multiple pregnancy history was an independent risk factor for hemangioma area > 6 cm2. Its incidence was 17.896 times that of tumor area ≤6 cm2.ConclusionOral propranolol combined with pingyangmycin sclerotherapy is effective with few adverse reactions in treatment of 3-month old infants with hemangioma, which is worthy of clinical application. Moreover, it is essential to screen mothers' records of taking medication during pregnancy. Pregnant women taking progesterone with gestational age <37 weeks and several pregnancies should be given timely intervention treatment to avoid the occurrence and development of infant hemangiomas.

Key words:

Hemangioma is infants, Propranolol, Pingyangmycin, Children