摘要
目的探讨外用咪喹莫特与噻吗洛尔和激光治疗婴幼儿浅表型血管瘤的临床疗效。方法回顾性选取2020年1月至2021年1月间空军军医大学第二附属医院收治的147例婴幼儿浅表型血管瘤患儿,依据治疗方式不同分为激光组55例、噻吗组47例和咪喹组45例。激光组患儿行Cynergy双波长脉冲激光仪治疗,噻吗组患儿行0.5%马来酸噻吗洛尔滴眼液治疗,咪喹组患儿行5%咪喹莫特乳膏治疗,比较三组患儿血管瘤颜色、厚度、颜色变化、临床疗效及不良反应。结果激光组患儿治疗有效率为89.1%,噻吗组治疗有效率为83.0%,咪喹组治疗有效率为66.7%。三组患儿治疗效果比较,差异有统计学意义(P<0.05)。激光组患儿平均治疗用时和达Ⅳ级疗效用时均短于噻吗组和咪喹组,差异均有统计学意义(均P<0.05);噻吗组和咪喹组比较,差异无统计学意义(P>0.05)。治疗后,三组患儿病灶处各项评分均有所提高,且激光组患儿病灶处厚度、面积、颜色和总评分均高于噻吗组和咪喹组,噻吗组病灶处颜色和总评分均高于咪喹组,差异均有统计学意义(均P<0.05)。激光组患儿结痂/脱屑发生率低于噻吗组和咪喹组,红肿和局部色素减退/沉着发生率高于噻吗组和咪喹组,咪喹组患儿浅表性瘢痕发生率高于激光组和噻吗组,差异均有统计学意义(均P<0.05)。结论激光治疗婴幼儿浅表型血管瘤效果快速,但不良反应较多;外用噻吗洛尔显效速度不及激光治疗,但治疗过程相对安全稳定;外用咪喹莫特治疗效果不及以上两种方式,且不良反应较大。
Objective To explore and analyze the efficacy of topical imiquimod and timolol and la-ser for the treatment of superficial hemangioma in infants and young children.Methods A total of 147 in-fants with superficial hemangioma were retrospectively selected at The Second Affiliated Hospital of Air Force Medical University from January 2020 to January 2021.Baaed on different treatment methods,they were categorized into a laser group(55 children),a timolol group(47 children)and an imiquimod group(45 children).The laser group were treated with Cynergy dual-wavelength pulse laser.The timolol group was treated with 0.5%timolol maleate ophthalmic solution,and the imiquimod group was treated with 5%imiquimod cream.The color,thickness,and color changes of the hemangioma,clinical efficacy and adverse reactions were compared among the three groups.Results After the treatment,the efficacy rate was 89.1%,83.0%and 66.7%,respectively in the laser group,the timolol group and the imiquimod group(P<0.05).The general treatment duration and the treatment duration for grade IV curative effect were short in the laser group than in the timolol group and the imiquimod group(all P<0.05).There was no significant difference in the treatment duration between the timolol group and the imiquimod group(P>0.05).After the treatment,the scores for different aspects of lesions increased in the three groups.The scores of thickness,area and color of lesions and the overall score of lesions were higher in the laser group than in the timolol group and the imiquimod group(all P<0.05).The scores of color and the overall score of lesions were higher in the timolol group than in the imiquimod group(all P<0.05).The incidence of crusting/desquamation was lower in the laser group than in the rest two groups,the incidence of red and swollen and hypopigmentation and perpigmentation was higher in the laser group than in the rest two groups and the incidence of superficial scar was higher in the imiquimod group than in the rest two groups(all P<0.05).Conclusion Laser treatment has a fast effect but has many adverse effects.The efficacy speed of topical timolol is not as fast as laser treatment but the treatment process is relatively safe and stable.The treatment effect of topical imiquimod is not as good as the above two methods and the adverse effects are rel-atively high.
作者
董高宏
王小霞
刘涛
DONG Gao-hong;WANG Xiao-xia;LIU Tao(Department of Dermatology,The Second Affiliated Hospital of Air Force Medical University,Xi'an 710038,China)
出处
《中国肿瘤临床与康复》
2021年第10期1185-1188,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
