口服普萘洛尔治疗婴幼儿血管瘤停药后复发的研究进展

Research Progress on Oral Propranolol Therapy in the Treatment of Infantile Hemangioma Recurrence after Discontinuation

摘要: 婴幼儿血管瘤(IH)是儿童最常见的血管肿瘤，口服普萘洛尔作为一线疗法虽有效率高，但停药后复发问题突出，严重影响治疗效果。本文综述口服普萘洛尔治疗婴幼儿血管瘤停药后复发的相关研究，阐述普萘洛尔治疗IH的机制，分析复发影响因素，包括停药后的残余病变、血管瘤分布、类型、治疗起始年龄、停药年龄和方式，而性别和溃疡的影响尚存争议。基于现有证据，建议临床通过高危因素识别、个体化停药方案及长期随访降低复发风险。未来需深入探索复发机制并开发精准预测模型，以优化临床决策。

Abstract: Infantile hemangioma (IH) is the most common vascular tumor in children. Although oral propranolol is an effective first-line therapy, recurrence after discontinuation remains a significant issue, severely impacting treatment outcomes. This paper reviews studies on the recurrence of infantile hemangiomas following the discontinuation of oral propranolol, discusses the mechanisms underlying propranolol’s treatment of IH, and analyzes factors contributing to recurrence. These include residual lesions after treatment cessation, hemangioma distribution and type, age at treatment initiation, as well as the age and method of discontinuation. The roles of gender and ulceration in recurrence remain controversial. Based on the existing evidence, it is recommended that clinical practice incorporate risk factor identification, individualized discontinuation plans, and long-term follow-up to reduce the risk of recurrence. Future research should focus on further exploring the mechanisms of recurrence and developing precise predictive models to optimize clinical decision-making.