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題 名 | The Efficacy of Low-dose Propranolol in the Proliferative Phase of Infantile Hemangiomas=低劑量心律錠治療增生期嬰兒血管瘤的成效 |
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作 者 | 羅世倫; 郭宇正; 陳明庭; 李建智; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 28:1 2019.03[民108.03] |
頁 次 | 頁30-40 |
分類號 | 417.517 |
關鍵詞 | 心律錠; 增生期; 嬰兒血管瘤; 軟組織腫瘤; Infantile hemangiomas; Propranolol; Involution; Proliferation; |
語 文 | 英文(English) |
中文摘要 | 背景:嬰兒型血管瘤是嬰兒最常見的軟組織腫瘤。這腫瘤是血管內皮細胞過度增生造成的,根據臨床表徵可以分成增生期與消退期。心律錠近期被發現能有效治療此類型的血管瘤,並且已成為廣為接受的治療方式。目的及目標:我們提出目前台灣最多的病例統計來探討使用心律錠治療台灣族群增生期的嬰兒血管瘤。我們同時分析使用心律錠治療增生期嬰兒血管瘤之後腫瘤的消退程度。我們使用相對於目前發表文獻較低的治療劑量來避免較多的併發症和醫療花費,並且利用數位相片去客觀分析治療前後的腫瘤消退率。材料及方法:我們回顧性去看所有於單一醫院從2011年9月至2015年12月期間,使用口服心律錠治療增生期嬰兒型血管瘤的病人,利用影像分析軟體去分析和量測病人一系列的數位相片,得知增生期腫瘤治療後的消退率。結果:我們評估了262個病人接受口服心律錠治療增生期嬰兒型血管瘤。最終納入72個病人,在腫瘤增生期間內有接受心律錠治療至少持續5個月的期間。平均治療期間為6.6±1.0個月,平均追蹤時間為16.7±9.1個月。整體腫瘤大小的消退率為37.6%。其中病人於腫瘤增生期能達到良好的腫瘤消退佔了41.7%,部分的腫瘤消退佔了23.6%,少許的腫瘤消退佔了18.1%,沒有任何腫瘤消退佔了16.7%。增生期嬰兒型血管瘤的病人對藥物治療有消退反應高達83.3%。結論:使用口服心律錠治療增生期嬰兒型血管瘤是安全與有效的方式。我們使用客觀的數位照片分析發現:低劑量的心律錠(1-1.5mg/kg/day)的治療反應率可達83.3%。 |
英文摘要 | Background: Infantile hemangiomas are the most common soft tissue tumors of infancy. These tumors result from endothelial hyperplasia, and their clinical course consists of a proliferative phase and involuting phase. Propranolol has recently been reported to be a highly effective treatment for hemangiomas and is emerging as a widely accepted treatment option. Aim and Objectives: We present a case series in which propranolol was used to treat infantile hemangiomas in the proliferative phase. An analysis of the involution rate of these infantile hemangiomas treated with our propranolol treatment protocol is also presented. Relatively low doses of propranolol were prescribed for the cases in this study compared to those in other published articles in order to avoid complications and decrease medical costs, and the efficacy of this approach was demonstrated by digital photographs and analysis. Materials and Methods: We retrospectively reviewed the clinical images and medical records of our patients with infantile hemangiomas who received oral propranolol during the proliferative phase at a single institute between September 2011 and December 2015. The series of digital photographs were analyzed with Image J graphics software to measure the lesions size involution rate. Results: We evaluated a total of 262 patients who received propranolol treatment, ultimately including 72 patients who were treated for at least 5 months in the proliferative phase. For those 72 patients, the average treatment period was 6.6 ± 1.0 months, and the mean follow-up time was 16.7 ± 9.1 months. The overall size involution rate was 37.6%. Patients in the proliferative phase had a great tumor involution rate of 41.7%, while the rates of partial tumor involution, minimal tumor involution, and no tumor involution were 23.6%, 18.1%, and 16.7%, respectively. The response rate of the patients was as high as 83.3%. Conclusion: Using propranolol to treat infantile hemangiomas during the proliferative phase is safe and effective. We proved the efficacy (83.3%) of low-dose propranolol (1-1.5mg per kilogram per day) using objective digital methods. |
本系統中英文摘要資訊取自各篇刊載內容。