| Background:Infantile hemangioma is one of the most common tumors in infants,which often occurs in the head and neck,leading to infant facial deformity,dysfunction and other adverse consequences.Beta blockers have been proved to be effective in the treatment of infantile hemangioma,while there are many kinds of drugs and ways of use.Up till now,the local application of beta blockers is common in the treatment of superficial infantile hemangioma,but there is no comprehensive meta-analysis of relevant literature to prove its efficacy and safety.Objective:The purpose of this study is to systematically evaluate the efficacy and safety of local application of beta blockers in the treatment of superficial infantile hemangioma by meta-analysis,and to provide evidence-based medical evidence for clinical treatment.Methods:Independent use of subject words and free words in CNKI,CBM,VIP,WanFang,PubMed,Web of Science,Cochrane Library,EMBASE and other databases were searched online.And the search time was limited from January 2008 to February 2021 According to the inclusion and exclusion criteria,literatures related to beta blockers in the treatment of superficial infantile hemangioma were included.According to different research types,the quality of literature was evaluated.Revman 5.3.1 software was used for meta-analysis of the selected literatures to evaluate the efficacy and safety.Results:A total of 30 articles were included in this meta-analysis.For superficial infantile hemangioma,topical timolol had a significant therapeutic effect compared with observation[RR=4.34,95%Cl(3.13,6.03),P<0.05],topical timolol and oral propranolol had the same curative effect[OR=1.55,95%CI(0.85.2.80),P>0.05];combined use of timolol and oral propranolol had better curative effect than single use of timolol or oral propranolol alone[OR=5.38,95%CI(1.58,18.35),P<0.05],[OR=5.73,95%CI(2.07,15.88),P<0.05];the efficacy of topical timolol was better than that of topical imiquimod[OR=2.63,95%CI(1.20,5.78),P<0.05];the efficacy of topical propranolol was similar to that of oral propranolol[OR=0.50,95%CI(0.14,1.75),P>0.05],The efficacy of topical 595nm pulsed laser was better than that of topical timolol[OR=0.40,95%CI(0.24,0.66),P<0.05],and there was no significant difference between the efficacy of topical 595nm pulsed laser and topical timolol alone[OR=3.58,95%CI(0.24,52.59),P>0.05],[OR=1.00,95%CI(0.64,2.20),P>0.05].The safety of topical timolol was higher than that of oral propranolol[OR=0.25,95%Cl(0.09,0.67),P<0.05].There was no significant difference in the incidence of adverse reactions between topical timolol and oral propranolol alone[OR=3.24,95%CI(0.12,87.13),P>0.05],[OR=0.28,95%CI(0.02,3.10),P>0.05]There was no significant difference in the incidence of adverse reactions between topical timolol and topical imiquimod[OR=0.12,95%CI(0.01,1.48),P>0.05];there was no significant difference in the incidence of adverse reactions between topical and oral propranolol[OR=0.27,95%CI(0.03,2.15),P>0.05],There was no significant difference in the incidence of adverse reactions between topical timolol and topical 595nm pulsed laser therapy[OR=0.28,95%CI(0.06,1.37),P>0.05].There was no significant difference in the incidence of adverse reactions between the two groups[OR=0.92,95%CI(0.38,2.24),P>0.05],[OR=0.53,95%CI(0.23,1.21),P>0.05].Conclusions:According to the meta-analysis,beta blockers(timolol,propranolol)have good efficacy and high safety in the treatment of superficial infantile hemangioma.Local application of timolol combined with oral propranolol or local application of timolol combined with laser therapy can be the first choice for the treatment of superficial infantile hemangioma. |
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