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首页> 外文期刊>JAMA otolaryngology-- head & neck surgery >Propranolol Therapy for Reducing the Number of Nasal Infantile Hemangioma Invasive Procedures
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Propranolol Therapy for Reducing the Number of Nasal Infantile Hemangioma Invasive Procedures

机译：普萘洛尔疗法可减少鼻婴儿血管瘤侵袭性手术的次数

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IMPORTANCE Propranolol therapy is changing the treatment paradigm for infantile hemangioma. This study addresses the effect of propranolol therapy on the treatment of nasal infantile hemangioma (NIH), an area that often does not respond to medical therapy.OBJECTIVE To determine if propranolol treatment is associated with fewer invasive treatments for NIH.DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study conducted within a single pediatric institution's multidisciplinary vascular anomaly program for patients with NIH treated'between January 1,2003, and December 31,2011. Three NIH cohorts were compared: prepropranolol (20 in group 1; 2003-2009), propranolol (25 in group 2; 2009-2011), and nonpropranolol (13 in group 3; 2009-2011) treatment.INTERVENTIONS Analysis of systemic medical, laser, or surgicaltherapies for NIH.MAIM OUTCOMES AND MEASURES The study plan was created to detect a change in invasive therapy for NIH. Data collected included presenting age, sex, affected nasal subunits, infantile hemangioma morphologic characteristics, treatment type and number, and primary treating service. An NIH grading system, based on nasal subunit involvement, helped quantify treatment change. Descriptive statistics summarized data, and a Cox proportional hazards regression model evaluated propranolol use and the likelihood of invasive treatments (surgical excision or laser).RESULTS Of the 95 patients identified, 58 met inclusion criteria: 20 in group 1 (mean age, 4.8 months), 25 in group 2 (mean age, 4.9 months), and 13 in group 3 (mean age, 4.9 months). Nasal infantile hemangiomas involved the nasal tip subunit in 33 of 58 patients (56.9%). Eight of 13 patients (61.5%) in group 3 frequently had small NIH (grade 1), Patients in group 2 were less likely to undergo any invasive treatments (relative risk, 0.44; 95% Cl, 0.27-0.73), have surgical excision only (0.45; 0.15-1.38), or undergo laser treatment only (0.44; 0.27-0.78) compared with those in group 1. Patients with higher-grade NIH had more medical or invasive therapy, but invasive procedures were carried out in each subgroup defined by grade.
机译：重要信息普萘洛尔疗法正在改变婴儿血管瘤的治疗方式。这项研究旨在探讨普萘洛尔对鼻腔婴儿血管瘤（NIH）的治疗作用，该领域通常对药物治疗无反应。目的确定普萘洛尔治疗是否与NIH的侵入性治疗较少相关。设计，设置和参与者于2003年1月1日至2011年12月31日期间，在单个儿科机构的多学科血管异常计划中对NIH患者进行的回顾性队列研究。比较了三个NIH队列：前普萘洛尔（第1组为20; 2003-2009），普萘洛尔（第2组为25; 2009-2011）和非普萘洛尔（第3组为13; 2009-2011）治疗。激光或NIH.MAIM的手术治疗方法和措施本研究计划旨在检测NIH的侵入性治疗方法的变化。收集的数据包括年龄，性别，受影响的鼻部亚单位，婴儿血管瘤的形态特征，治疗类型和数量以及主要治疗服务。基于鼻下单元受累的NIH分级系统有助于量化治疗变化。描述性统计数据汇总，并使用Cox比例风险回归模型评估普萘洛尔的使用和侵入性治疗（手术切除或激光治疗）的可能性。结果在95例患者中，有58例符合纳入标准：第1组20例（平均年龄，4.8个月） ），第2组25个（平均年龄4.9个月）和第3组13个（平均年龄4.9个月）。鼻婴儿血管瘤涉及58例患者中的33例（56.9％）的鼻尖亚单位。第3组的13位患者中有8位（61.5％）经常患有小NIH（1级），第2组的患者接受任何侵入性治疗的可能性较小（相对风险，0.44; 95％Cl，0.27-0.73），有手术切除与第1组相比，仅（0.45; 0.15-1.38）或仅接受激光治疗（0.44; 0.27-0.78）。NIH等级较高的患者接受了更多的药物或侵入性治疗，但在每个亚组中均进行了侵入性手术由等级定义。

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