Hemangioma (otherwise - infant hemangioma) - a benign tumor of endothelial cells.
Endothelial cells - these are the cells that line the blood vessels inside the body, which directly connects the appearance hemangioma Bookmark violations of the circulatory system, but the true cause of hemangiomas is still unclear.
The modern view of hemangioma
There is an opinion, according to which the hemangioma is equally as tumor diseases, as well as a local manifestation of vascular hyperplasia. Despite the fact that currently there is no scientific prove or disprove this theory, clinical practice shows that the fundamental difference between hemangioma tumors and hyperplasia both vessels - no.
In fact, hemangioma - a plate (in 80% of cases occurring in the skin, but perhaps its origin in any organ or tissue) with jagged, sharp edges, raised above the surface of the skin and has a deep red color, consisting of healthy and abnormal cells endothelial, platelet and connective tissue elements, together forming a structure resembling a remotely normal blood vessel.
In 80% of cases there is only one entity, most often on the face, neck and head, but possibly multiple occurrence of hemangiomas in different parts of the body.
For a hemangioma is characterized by the following features:
- most often it occurs even in utero, and can be seen immediately after birth
- incidence in children - 10%
- girls hemangioma occurs in 7 times more likely than boys
- hemangioma is capable of involution, that is, after 5-7 years, it begins to develop in the opposite direction until the complete disappearance.
danger hemangioma
Hemangioma - tumor of vascular origin, and therefore it is dangerous primarily bleeding appearing due to the instability of tumor vessel wall. Although not typical of the spontaneous appearance of bleeding, any injury can easily lead him to her.
If the hemangioma is located on the skin, the bleeding can be easy to spot and stop. But the localization of a hemangioma in the tissues of the internal organs, bleeding for a long time may go unnoticed, and the volume of expired blood - much larger, which may lead to death.
Also, tissue hemangiomas tends to filter out of the blood platelets, which increases the likelihood of bleeding.
Photo: site of the Department of dermatology Tomsk Military Medical Institute
Using propranolol for the treatment of hemangiomas
In 2008, the research team Pediatric Clinic "Bordeaux" powerful anti-angiogenic (inhibits the proliferative vascular growth component) has been detected in France, the effect of propranolol.
According to the research protocols, patient with skin hemangioma, which was treated with prednisone developed serious side effect - obstructive hypertrophic cardiomyopathy.
For relief of side effect of propranolol has been appointed, and the next day the hemangioma changed its color from red to purple and became softer. One year after the publication of this observation articles began to appear, which was confirmed by a pronounced positive effect of propranolol in the treatment of hemangiomas.
At the moment, the majority of studies on antiangiogenic effect of propranolol has not completed, but it is already possible to speak with confidence about the following features of its application for the treatment of hemangioma:
propranolol categorically contraindicated Children with the following diseases:
- sinus bradycardia,
- antrioventrikulyarnaya blockade
- heart failure,
- bronchial asthma,
- episodes of bronchospasm,
- perifericheskime impaired blood flow, for example - Raynaud's disease.
Propranolol has the following therapeutic effects:
1. The initial effect (first 3 days after starting the application), which is characterized by changes in color and consistency of the tumor due to narrowing of the vessels by the action of the drug.
2. Intermediate - suspension growth hemangiomas, signaling activity due to suppression of growing cells.
3. Long-term - the destruction (apoptosis) of cells in the capillaries of the tumor, hemangioma regression, followed within 2-3 months.
Observe the following assignment rules and treatment with propranolol:
1. In the first 6 hours after application of the preparation of the pore, every 30 minutes to produce a blood pressure measurement and pulse. If during this time the side effects not found the child can be discharged home.
2. Every month to photograph and measure the tumor to assess the dynamics.
3. Regularly weight measurement, the curves of pulse and blood pressure for dose adjustment.
Thus, on the basis of a preliminary study, the efficiency of propranolol undoubtedly higher than the efficiency of any from previously used in the treatment of hemangioma means at approximately the same frequency of occurrence of adverse effects.
It should also be said that in Russia and some other countries, there are so-called disease treatment protocols that dictate specific treatment algorithm.
At the moment, most of these countries propranolol is not included in the list of protocol of drugs used to treat hemangiomas (which is associated with insufficient scientific evidence of its safety), and therefore its use is not It allowed.