ABSTRACT
Objective@#To observe the treatment effect of oral propranolol combined with topical timolol maleate for infantile maxillofacial mixed hemangioma and provide evidence for clinical treatment.@*Methods@# Ninety-seven cases of infantile maxillofacial mixed hemangioma were enrolled. The cases were randomly divided into A and B groups: 50 cases in group A were treated with oral propranolol combined with topical timolol maleate, and 47 cases in group B were treated with oral propranolol only. The changes in the color, volume, and texture of the tumors were recorded before and after treatment, and color ultrasonography of the lesion area was performed. The follow-up time was 1-12 months. The differences in the curative effect, effective time and adverse reaction between the two groups were compared. @*Results @#The effective rate of group A was 92.0% (46/50) and that of group B was 74.5% (35/47), with a statistical significance (P < 0.05). The mean time of treatment in group A was 4.2 months and that in group B was 5.5 months. Compared with group B, the treatment time of group B was shorter (t=3.211, P < 0.05), and no serious adverse reactions occurred in both groups.@*Conclusion@#Oral propranolol combined with topical timolol maleate is effective in the treatment of mixed hemangioma of the maxillofacial region in infants.
ABSTRACT
Objective To investigate the application effect of interventional surgery in the treatment of facial superficial mixed hemangi-oma through the laryngeal mask ventilation under desflurane anesthesia. Methods In the period from February 2016 to April 2017 in our hospital 118 cases of facial superficial hemangioma under interventional surgery in infants( aged 3-15 months) were retrospectively analyzed;according to the difference of anesthesia,they were divided into control group (51 cases) and observation group (67 cases);the two groups of children were administered sufentanil anesthesia, in the control group laryngeal mask airway under propofol, the observation group was giv-en under laryngeal mask airway inhalation of desflurane maintenance. Then was compared the difference in anesthesia monitoring indexes of the two groups, such as mean arterial pressure ( MAP) , saturation of pulse oximetry ( SpO2 ) , heart rate ( HR) , end-tidal carbon dioxide ( ETCO2 ) , laryngeal mask removal time, loss of consciousness time, laryngeal mask removal time, consciousness recovery duration, clinical efficacy and intraoperative and postoperative adverse reactions difference. Results For the control group, the laryngeal mask removal time and consciousness recovery time length were significantly longer than those of the observation group and the difference was statistically signifi-cant (P<0. 05);after anesthesia induction, the laryngeal mask insertion time, operation start time and laryngeal mask removal time, MAP and HR of the observation group and the control group were lower than those before anesthesia induction, and MAP and HR of control group were lower than those of the observation group and the deference was statistically significant (P<0. 05). The total efficiency of the observa-tion group (97. 02％) was significantly higher than the control group (88. 24％), the adverse reaction rate (23. 52％) of children in the control group was significantly higher than that (7. 46％) of those in the observation group, and the differences were statistically significant (P<0. 05). Conclusion In the infant facial superficial hemangioma interventional surgery, laryngeal mask airway can be used for anesthe-sia maintenance for desflurane effect and clinical curative effect in the effective protection of anesthesia at the same time, but also can reduce the risk of anesthesia and intraoperative blood pressure fluctuations, especially in the stabilization of hemodynamics of the patients.
ABSTRACT
Objective:To treat the mixed and deeper infantile hemangioma with ladder dosage propranolol, and to explore its efficacy and safety.Methods:A total of 98 infants with hemangioma were treated by ladder treatment of propranolol.Before treatment,comprehensive assessments of electrocardiogram(ECG),heart color ultrasound, blood glucose,liver function,kidney function,myocardial enzymes and blood routine were conducted.After excluding contraindications,the dose of propranolol incrementally doubled from 0.5 mg·kg-1·d-1 to 4.0 mg·kg-1·d-1.Propranolol was taken 3 times a day.Before and after medication for 1 and 2 h,ECG was monitored.The changes of tumor size,texture,color and other changes or an onset of adverse reactions were dynamicly observed.The infants were visited every month.The efficacy was evaluated using Achauer system.Results: After medication,98 cases had different degrees of color changes or tumor consistency softening.After the dosage of propranolol was increased to 4.0 mg·kg-1·d-1,the change of tumor was the fastest.According to the 4-grade method, there were 84 cases(85.71%) as gradeⅣ (excellent),2 cases (2.04%) as grade Ⅲ (good),4 cases (4.08%) as gradeⅡ (medium)and 8 cases (8.16%) as gradeⅠ (poor).The curative effect of mixed hemangioma was better than that of deeper hemangioma(P<0.05).The recovery time of 74 cases of hemangiomas was 6 months.The major adverse reactions were heart rate decline(5/98,5.10%),drowsiness(3/98,3.06%),diarrhea(7/98,7.14%),loss of appetite (1/98,1.02%), and convulsions (2/98,2.04%).After treatment,all adverse reactions disappeared.Two months after drug withdrawal there were 4 cases of recurrence,and they were continously treated with propranolol.Conclusion: The efficacy of oral ladder dosage propranolol in treatment of mixed and deeper infantile hemangioma is increased significantly and there are no significant adverse reactions.
ABSTRACT
Hemangioma in the gastrointestinal tract rarely occurs especially in the stomach compared with the small and large intestine. A 45-year-old man was admitted with pneumonia. After hematemesis, the authors performed gastroscopy, which revealed active bleeding on the huge ulcer on the antrum of the stomach and multiple erosive lesions on the whole stomach. After multiple submucosal hypertonic saline injection and hemoclipping at the huge ulcerative lesion, ulcer bleeding stopped. Three days later, recurrent massive upper gastrointestinal bleeding occured at the same site of the stomach. To prevent futher recurrent bleeding, total gastrectomy with esophagojejunostomy and splenectomy was done. The histologic diagnosis of the ulcerative lesion was hemangioma of mixed type. We report this rare case with the brief literature review.