Clinical Analysis Of Propranolol Combined With Local Sclerotherapy In Treating Infantile Parotid Hemangioma

Background:Infantile hemangioma is one of the relatively common benign vascular tumor in infants.Although it has a self-limited course of disease,many complications may occur without early intervention.These complications may influence the appearance and local function of the children and even be life-threatening.At present,the treatment methods for hemangioma are varied.Among all these methods,as a combination therapy,oral propranolol combined with local sclerotherapy of lauromacrogol and triamcinolone acetonide is superior to monotherapy to a certain extent and has been recognized by many experts.Infantile parotid hemangioma,as the most common benign tumor in parotid gland of children,is often considered to have poor response to a variety of treatments due to its unique biological characteristics.However,there is no clinical study on the treatment of parotid hemangioma with propranolol combined with local sclertherapy.Objective:This study aims to analyze whether parotid hemangioma is more difficult to treat than other hemangioma when using propranolol combined with local sclerotherapy.Besides,the factors affecting the efficacy of this combination therapy on parotid hemangioma were further analyzed.Method:48 children with parotid hemangioma who received the above combination therapy from January 2016 to August 2018 were collected in parotid hemangioma group.Children with hemangioma at other sites who received the above combination therapy at the same time were screened out,and 50 children were randomly selected with R software to be collected in the control group.Gender,age of treatment initiation,subclassification,tumor size,tumor thickness,blood flow signal of tumor,medication duration,sclerotherapy frequency,efficacy,recurrence or not and other information were collected.Mann-Whitney U test was used to compare the efficacy,medication duration and sclerotherapy frequency between the two groups.Continuous correction chi-square test was conducted to compare the recurrence rate of the two groups.Logistic regression was performed to analyze the factors affecting the efficacy of the above combination therapy on parotid hemangioma.All statistical analyses were performed through SPSS 22.0.Results:Mann-Whitney U test showed that there was no significant difference in the efficacy(P=0.171)and slcerotherapy frequency(P=0.122)between the two groups,while oral medication duration was longer in children with parotid hemangioma(P=0.004).The chi-square test showed no statistically significant difference in the recurrence rate between the two groups(P=0.949).Logistic regression showed that,the OR value of at least one grade higher of efficacy in children aged 1-4 months was 6.265 times of that in children aged 5-8 months(P=0.023),and was 45.422 times of that in children aged 9-12 months(P<0.001).The OR value of at least one grade higher of efficacy in children aged 5-8 months was 7.250 times of that in children aged 9-12 months(P=0.031).The OR value of at least one grade higher of efficacy in children with mixed hemangioma was 5.425 times of that in children with deep hemangioma(P=0.037).Conclusion:Using oral propranolol combined with local sclerotherapy of lauromacrogol and triamcinolone acetonide needs longer medication duration on parotid hemangioma than on hemangioma at other sites.The efficacy of the above combination therapy on parotid hemangioma is related to the age of treatment initiation and the subclassification of hemangioma.The earlier the treatment initiates,the better the efficacy will be.Initiating treatment within 4 months will come to the best efficacy.Besides,the efficacy of mixed hemangioma is better than that of deep hemangioma.