口服普萘洛尔治疗婴幼儿血管瘤中国专家共识

上海口腔医学 ›› 2016, Vol. 25 ›› Issue (3): 257-260.

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口服普萘洛尔治疗婴幼儿血管瘤中国专家共识

郑家伟^{1*, *}, 王绪凯², 秦中平³, 范新东⁴, 李凯⁵, 杨耀武⁶, 霍然⁷, 刘少华⁸, 赵吉宏⁹, 汪小勇¹⁰, 周德凯^{11*, *}

1.上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面-头颈肿瘤科,上海 200011;
2.中国医科大学口腔医学院口腔颌面外科, 辽宁沈阳 110001;
3.山东省临沂市肿瘤医院省A级血管瘤特色专科,山东临沂 276001;
4.上海交通大学医学院附属第九人民医院介入科,上海 200011;
5.复旦大学附属儿科医院外科,上海 201102;
6.第四军医大学口腔医学院头颈肿瘤外科,陕西西安 710032;
7.山东省立医院烧伤整形美容外科,山东济南 250021;
8.山东大学齐鲁医院口腔颌面外科,山东济南 250012;
9.武汉大学口腔医学院口腔外科,湖北武汉 430079;
10.上海曹安医院血管瘤科,上海 201804;
11.重庆医科大学附属儿童医院胃肠新生儿外科血管瘤专科,重庆 400014

收稿日期:2016-01-18 修回日期:2016-03-20 出版日期:2016-06-25 发布日期:2016-07-22
通讯作者: 郑家伟,E-mail：davidzhengjw@sjtu.edu.cn;周德凯,E-mail：zhoudekai6267@qq.com。^*共同通信作者
作者简介:郑家伟(1964-),男,医学博士,教授,博士（后）研究生导师,主要从事血管瘤与脉管畸形的临床与基础研究
基金资助:
国家自然科学基金（81470755）; 国家临床重点专科建设项目〔国卫办医函（2013）544号〕

Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas

ZHENG Jia-wei¹, WANG Xu-kai², QIN Zhong-ping³, FAN Xin-dong⁴, LI Kai⁵, YANG Yao-wu⁶, HUO Ran⁷, LIU Shao-hua⁸, ZHAO Ji-hong⁹, WANG Xiao-yong¹⁰, ZHOU De-kai¹¹

1. Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
2. Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University;
Liaoning Institute of Dental Research. Shenyang 110001, Liaoning Province;
3. Special Department of Hemangioma, Tumor Hospital of Linyi City. Linyi 276001, Shandong Province;
4. Department of Intervention Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
5. Department of Pediatric Surgery, Children's Hospital of Fudan University. Shanghai 201102;
6.Department of Head and Neck Tumor Surgery, School of Stomatology, The Fourth Military Medical University. Xi'an 710032, Shaanxi Province;
7. Department of Aesthetic Plastic and Burn Surgery, Shandong Provincial Hospital, Shandong University. Jinan 250021,Shandong Province;
8. Department of Oral and Maxillofacial Surgery, Qilu Hospital, Shandong University. Jinan 250012,Shandong Province;
9.Department of Oral Surgery, School of Stomatology, Wuhan University. Wuhan 430079, Hubei Province;
10. Department of Infantile Hemangioma, Shanghai Cao'an Hospital. Shanghai 201804;
11. Department of Infantile Hemangioma, Gastrointestinal and Neonatal Surgery, Children's Hospital of Chongqing Medical University. Chongqing 400014, China

Received:2016-01-18 Revised:2016-03-20 Online:2016-06-25 Published:2016-07-22

摘要/Abstract

摘要： 婴幼儿血管瘤是儿童最常见的良性血管肿瘤,过去曾采用过多种方法进行治疗,包括口服或注射途径的药物治疗(激素、长春新碱、α干扰素、平阳霉素),激光治疗,放射性核素贴敷或局部注射,冷冻治疗,手术治疗等,其疗效不一,副作用或并发症多且较严重。自2008年意外发现β受体阻滞剂普萘洛尔对血管瘤具有显著效果以来,口服普萘洛尔已经成为婴幼儿血管瘤的首选治疗,但有关药物剂量、次数、用药年龄、疗程、用药方案、监测、不良反应等,仍无统一意见。为规范普萘洛尔在婴幼儿血管瘤治疗中的应用,避免过度治疗或治疗不足,减少并发症的发生,经国内多名不同专业从事婴幼儿血管瘤诊治的知名专家共同讨论,形成普萘洛尔治疗婴幼儿血管瘤的中国专家共识,供临床医师参照执行。

关键词: 普萘洛尔, 婴幼儿血管瘤, 专家共识

Abstract: Infantile hemangioma (IH) is one of the most common benign vascular tumors in children. A variety of treatment methods have been documented for the management of IH over the past years, including pharmacotherapy via oral administration or injection of corticosteroids, vincristine, alpha interferon and bleomycin; laser therapy, radionuclide therapy, cryotherapy and excisional surgery. The therapeutic efficacy of each treatment modality is variable, while adverse effects or complications are common and sometimes serious. Since the serendipitous discovery of propranolol, a nonselective beta-adrenergic receptor blocker, being very efficacious in treating IH in 2008, oral propranolol has earned a role as a first-line medical therapy for complicated IH. However, the appropriate drug dosage, dosing regimen, time for initiation, optimal duration, monitoring for side effects remains controversial. To standardize the use of propranolol in treating IH, avoid overtreatment or under-treatment, as well as minimize complications, a Chinese experts consensus on the use of oral propranolol for treatment of IH has been approved and written by a multidisciplinary experts group based on an up-to-date literature review and repeated discussion.

Key words: Propranolol, Infantile hemangioma, Experts consensus

中图分类号:

R739.8

郑家伟, 王绪凯, 秦中平, 范新东, 李凯, 杨耀武, 霍然, 刘少华, 赵吉宏, 汪小勇, 周德凯. 口服普萘洛尔治疗婴幼儿血管瘤中国专家共识[J]. 上海口腔医学, 2016, 25(3): 257-260.

ZHENG Jia-wei, WANG Xu-kai, QIN Zhong-ping, FAN Xin-dong, LI Kai, YANG Yao-wu, HUO Ran, LIU Shao-hua, ZHAO Ji-hong, WANG Xiao-yong, ZHOU De-kai. Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas[J]. Shanghai Journal of Stomatology, 2016, 25(3): 257-260.

参考文献

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口服普萘洛尔治疗婴幼儿血管瘤中国专家共识

Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas

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