丙泊洛尔治疗婴幼儿深部血管瘤1例

Vargas Hernández Víctor Manuel, Luján Irastorza Jesús Estuardo, D. Carlos, Á. Daniela, Ávila-Pérez Felipe de Jesús, Loof-Esquivel Monica Stephanie, K. Alejandro, H. Roberto
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摘要

背景:婴儿血管瘤(IH)是由增殖内皮细胞组成的常见肿瘤。持续时间和增长率是可变的;有些生长得很差,而另一些则以不可预测的速度快速生长。尽管IH的相对频率和并发症的可能严重程度,但目前没有统一的治疗指南。虽然大多数并不令人担忧,但大约12%的IHs非常复杂;普萘洛尔已被用作一种治疗方法。目的:报告1例乳酸盐合并血管瘤用心得安治疗。病例报告:一个健康的新生儿,与存在小毛细血管扩张的右半颈部没有关联的产科创伤;健康的31岁母亲;3月龄发展过程中,毛细血管扩张覆盖区域变为深蓝色,开始有突出物生长,超声及血管磁共振示颈后间隙软组织呈分叶状肿块,纵、横直径分别为9.1x4.1x4.9cm,诊断为深部血管瘤;用丙泊洛尔治疗。讨论:无症状新生儿婴儿期颈部血管瘤在出生后前6个月得到临床控制,其中60%出现危及生命的气道症状;对血管瘤的诊断是由于其生长迅速,而不是由于周围结构的改变而使婴儿的健康处于危险之中。关于心得安的应用,在鉴定后立即给药,以避免以后的并发症。结论:系统应用心得安可消除血管瘤的特征性颜色,缩小血管瘤的大小。
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Propanolol as a treatment for deep infantile hemangioma: case report
Background: Infantile hemangiomas (IH) are common neoplasms composed of proliferating endothelial cells. The duration and the growth rate are variable; some grow very poorly, while others grow rapidly and at an unpredictable rate. Despite the relative frequency of IH and the possible severity of complications, there are currently no uniform treatment guidelines. Although most are not worrisome, about 12% of IHs are significantly complex; propranolol has been adopted as a treatment. Objective: Report a clinical case of lactanate with hemangioma treated with propranolol. Case report: A healthy newborn is presented, with the presence of small telangiectasias in the right hemicneck without association with obstetric trauma; of a healthy 31-year-old mother; During its evolution at 3 months of age, the area covered with telangiectasias turned deep blue and the growth of a protrusion began, ultrasound and angioresonance, showed soft tissues of the posterior cervical space a lobulated mass of 9.1x4.1x4.9cm in its longitudinal and transverse diameter respectively, diagnosing it as a deep hemangioma; which was treated with propanolol. Discussion: Asymptomatic newborns with infantile neck hemangiomas are clinically controlled for the first six months of life, 60% of them develop life-threatening airway symptoms; the identification of the hemangioma was due to its rapid growth and not due to the alteration of surrounding structures that put the well-being of the infant at risk. Regarding the application of Propranolol, its administration was immediately after its identification, to avoid future complications. Conclusion: administration of propranolol systemically eliminates the characteristic color and reduces the size of the hemangioma.
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