Su Rina, Qian Hua, Hu Cui, Li Wei, Li JiBin, Wu Bo, Gu Yang, Zhang Ting, Wu YaFen, Qian YingYing, Lu Hui
Department of Dermatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Dermatology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.
Front Med (Lausanne). 2024 Sep 13;11:1439449. doi: 10.3389/fmed.2024.1439449. eCollection 2024.
To investigate the safety and cost analysis of oral propranolol treatment for high-risk infantile hemangiomas starting from the outpatient setting.
A total of 41 high-risk infantile hemangioma patients from outpatient settings and 43 from inpatient settings were selected for the study. After routine pre-treatment examinations, patients were administered propranolol in a stepwise incremental dosing regimen over three consecutive days in the outpatient clinic. Changes in heart rate, blood pressure and PR interval before and after medication were compared. On the 10th day post-medication, liver and kidney functions, fasting blood glucose, tumor ultrasonography, and electrocardiogram were re-evaluated. The costs of treatment starting from the outpatient clinic (including pre-treatment examinations and the first three days of treatment) were calculated and compared with those of similarly managed inpatient cases.
The majority of patients exhibited a reduction in heart rate and blood pressure, as well as an extended PR interval after treatment of medication ( < 0.05), which remained within normal limits without clinical symptoms. On the 10th day post-medication, statistical differences in blood biochemistry and electrocardiograms were observed when compared to pre-treatment values ( < 0.05), but all values remained within normal ranges. No severe adverse reactions such as hypoglycemia occurred. Additionally, the cost of treatment from the outpatient clinic was significantly lower than that of inpatient care.
Oral propranolol treatment for high-risk infantile hemangiomas starting from the outpatient setting is associated with few adverse reactions and significantly reduced treatment costs. It is worthy of broader application in hospitals without dermatology wards.
探讨从门诊开始口服普萘洛尔治疗高危婴儿血管瘤的安全性及成本分析。
本研究共选取41例门诊高危婴儿血管瘤患者和43例住院高危婴儿血管瘤患者。在进行常规预处理检查后，患者在门诊连续三天采用逐步递增剂量方案服用普萘洛尔。比较用药前后心率、血压及PR间期的变化。用药后第10天，重新评估肝肾功能、空腹血糖、肿瘤超声及心电图。计算从门诊开始治疗的费用（包括预处理检查和治疗的前三天），并与类似管理的住院病例进行比较。
大多数患者用药治疗后心率、血压降低，PR间期延长（<0.05），且均在正常范围内，无临床症状。用药后第10天，与治疗前相比，血液生化及心电图有统计学差异（<0.05），但所有值均在正常范围内。未发生低血糖等严重不良反应。此外，门诊治疗费用明显低于住院治疗费用。
从门诊开始口服普萘洛尔治疗高危婴儿血管瘤不良反应少，治疗成本显著降低。在没有皮肤科病房的医院值得更广泛应用。
