發(fā)布時間：2018-03-26 06:37

  本文選題：階梯治療方案　切入點：普萘洛爾　出處：《吉林大學學報(醫(yī)學版)》2017年04期

【摘要】：目的:采用"階梯治療方案"口服普萘洛爾治療嬰幼兒混合型和深層血管瘤,探討其療效及安全性。方法:治療前對98例嬰幼兒混合型和深層血管瘤患兒進行全面評估,并行心電圖、心臟彩超、血糖、肝功能、腎功能、心肌酶和血常規(guī)檢查,排除禁忌證后均給予"階梯治療方案"口服普萘洛爾治療,劑量從0.5mg·kg-1·d-1逐漸增加至4.0mg·kg-1·d-1,分3次口服,服藥前和服藥后1和2h監(jiān)測心率,動態(tài)觀察瘤體大小、質(zhì)地、顏色等變化及患兒有無相關不良反應,每個月復診,按4級評分法進行療效評價。結果:服藥后,98例患兒瘤體均出現(xiàn)不同程度顏色變淺或質(zhì)地變軟,普茶洛爾劑量增至4.0mg·kg-1·d-1后瘤體性質(zhì)變化最快。療效評價,Ⅳ級(優(yōu))84例(85.71%),Ⅲ級(好)2例(2.04%),Ⅱ級(中)4例(4.08%),Ⅰ級(差)8例(8.16%)�；旌闲脱芰龅寞熜�(yōu)于深層血管瘤(P0.05)。74例血管瘤患兒痊愈時間為6個月。主要不良反應,心率下降5例(5/98,5.10%),嗜睡3例(3/98,3.06%),腹瀉7例(7/98,7.14%),食欲不振1例(1/98,1.02%),抽搐2例(2/98,2.04%),給予對癥處理后均恢復正常。停藥后2個月復發(fā)4例,繼續(xù)服藥仍然有效。結論:"階梯治療方案"口服普萘洛爾治療嬰幼兒混合型和深層血管瘤療效明顯,且無嚴重不良反應發(fā)生。
[Abstract]:Objective: to evaluate the efficacy and safety of oral propranolol in the treatment of mixed and deep hemangioma in infants. Methods: 98 cases of infantile mixed and deep hemangioma were evaluated before treatment. Electrocardiogram, color Doppler echocardiography, blood glucose, liver function, renal function, myocardial enzyme and blood routine examination were performed. After removing contraindications, propranolol was given orally to 0.5mg kg-1 d-1, and the dosage was gradually increased from 0.5mg kg-1 d-1 to 4.0mg kg-1 d-1. Heart rate was monitored before and 1 and 2 hours after taking the drug. The changes of tumor size, texture and color were observed dynamically. Results: all the 98 children's tumors showed light color or soft texture in varying degrees after taking the medicine, and the nature of the tumor changed most quickly when the dosage of prochlorolol was increased to 4.0mg kg-1 d-1, and the curative effect was evaluated. Grade 鈪，

本文編號：1666771