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目的:探讨n 90Sr-n 90Y β射线小剂量敷贴治疗与噻吗洛尔局部外用及其联合应用治疗浅表型婴幼儿血管瘤的疗效及安全性。n 方法:前瞻性纳入2013年5月14日至2017年4月11日广东省佛山市第一人民医院核医学科的400例浅表型血管瘤患儿[男126例，女274例，5.3(3.9，7.1)月龄]。按1∶1∶1∶1比例采用随机数字表法分为4组，分别采用噻吗洛尔局部外用(A组，对照组)、n 90Sr-n 90Y β射线小剂量敷贴(B组)、单程敷贴联合噻吗洛尔(C组)、多程敷贴联合噻吗洛尔(D组)治疗。随访至第104周(W104)，以W104前病灶治愈率为主要结局指标，比较不同治疗方案的疗效和安全性，采用Kruskal-Wallis秩和检验、Mann-Whitney n U检验、logistic回归等分析数据。n 结果:400例患儿共438处病灶，4组患儿及其病灶基线特征差异均无统计学意义(n χ2值：1.709～11.616，n H值：3.681～7.653，均n P>0.05)。截止至W104，失访病灶11处(2.51%，11/438)、早期退出32处(7.31%，32/438)、治愈357处(81.51%，357/438)、残留15处(3.42%，15/438)、反弹式增长23处(5.25%，23/438)，4组患儿均未出现严重不良事件。多因素分析示，病灶厚度[<3 mm组比≥3 mm组比值比(n OR)及其95% n CI为16.689(7.908～35.223); n χ2＝54.555，n P<0.001]和治疗方案[以A为对照组，B、C、D组n OR值(95% n CI)分别为16.842(6.179～45.901)、4.801(2.167～10.638)、39.127(10.468～146.243)；n χ2＝47.663，n P<0.001]是W104前治愈率的独立影响因子，n 90Sr-n 90Y小剂量敷贴治疗明显优于噻吗洛尔局部外用(n OR＝16.842，95% n CI：6.179～45.901)。联合噻吗洛尔可明显减少敷贴治疗累积吸收剂量[D比B：16(8，16)与16(16，24) Gy；n z＝-4.947，n P0.05). As of W104, 11 lesions (2.51%, 11/438) were lost follow-up, 32 lesions (7.31%, 32/438) were with early withdrawal, 357 lesions (81.51%, 357/438) were cured, 15 lesions (3.42%, 15/438) were with residual, 23 lesions (5.25%, 23/438) were with rebound growth, and no serious adverse events occurred in the 4 groups. Multivariate analysis showed that lesions thickness (<3 mmn vs ≥ 3 mm, odd ratio (n OR)=16.689, 95% n CI: 7.908-35.223; n χ2=54.555, n P<0.001) and treatment (considering group A as reference category,n OR (95% n CI) of group B, C and D were 16.842(6.179-45.901), 4.801(2.167-10.638) and 39.127(10.468-146.243), respectively; n χ2=47.663, n P<0.001) were independent factors affecting the cure rate of W104.n 90Sr-n 90Y low-dose fractionation radiotherapy was significantly better than topical timolol maleate (n OR=16.842, 95% n CI: 6.179-45.901), and the combination with timolol could significantly reduce the cumulative absorbed dose of radiotherapy (group D n vs B: 16(8, 16) n vs 16(16, 24) Gy; n z=-4.947, n P<0.001).n Conclusion:90Sr-n 90Y low dose applicator therapy is superior to topical timolol maleate for superficial IH, and the combination with timolol could significantly reduce the cumulative absorbed dose of applicator.n