プロプラノロール内服療法を行った乳児血管腫症例の中長期治療経過

Medium- to Long-Term Follow-Up of Infantile Hemangioma after Propranolol Therapy

はじめに

　乳児血管腫へのプロプラノロール内服治療はわが国で2016年に保険適用となり，現在では乳児血管腫の合併症もしくはその予防に対する最も安全かつ有効な治療に位置付けられている 1）2）。しかし，内服治療後の長期的な経過についてはいまだに不明なことも多く，手術やパルスダイレーザー（以下，PDL）照射などの追加治療が必要となる症例も少なくない。当院でプロプラノロール内服治療を行い，中長期的に経過観察できた乳児血管腫44例において，写真による治療効果の評価，手術やPDL照射などの追加治療の有無，また内服開始時期の影響や病型や部位による違いなどを検討した。

　We conducted medium- to long-term follow-up (4-11 years) of 44 cases of infantile hemangioma treated with oral propranolol at Shizuoka Childrenʼs Hospital. Changes in appearance, additional treatment, timing of treatment initiation, disease type, lesion location, etc. were evaluated from a multifaceted perspective. Good effects were obtained in cases in which treatment was started early. More than 50％ of cases required additional treatment such as surgery or laser therapy after oral therapy. Among these cases, trends were identified related to the timing of treatment initiation, changes in appearance, disease type, and lesion location. For cases with this tendency, it may be effective to individually set the target dose of oral propranolol or consider combining oral therapy with laser therapy.