Suchareva G. Pathogenic basing of correction of haemodynamics disturbances of children with congenital pathology of cardiovascular system

The dissertation is devoted the decision of an actual problem of children's cardiology – optimization of rendering of emergency medicine to children with a congenital pathology of cardiovascular system (CVS) by increase of diagnostics efficacy, perfection of prophylactic medical examination on the basis of studying of quality of life, indicators of adaptation of haemodynamics and results of surgical correction in catamnesis. There were 640 children with congenital pathology of CVS examined, from them 339 (53 %) were observed in various terms after surgical treatment. It is studied catamnesis of 84 pregnant women with the prenatal diagnosed pathology of a fetus’s heart on the basis of what it is developed, approved and introduced in practice of public health of AR Crimea and Ukraine algorithm of the organization of medical care to pregnant women with carrying out of fetal echocardiograms at various levels. It was revealed associative pathology of pre-cerebral vessels in 74 children with obstruction of an aorta on the basis of spent dopplerography of head and neck vessels that has allowed recommending including dopplerography of head and neck vessels in the report of observation of the given category of patients. The quality of life at different stages of observation is studied in children with congenital pathology of CVS and regularities and peculiarities of its change in dynamics before and after of surgical treatment depending on its volume, terms, severity of disease is revealed. The method of an estimation of quality of life is developed, patented and introduced. It is executed RCT and/or МRТ in 107 children at insufficient echocardiography – visualization, the CT – semiotics of some difficult congenital pathology of heart (CPH) is studied, and that has allowed recommending including the given methods of observation in algorithms of diagnostics in children with CPH methods which give more valuable diagnostic information than traditional methods. The catamnesis and adaptation of haemodynamics in children with rare congenital pathology of CVS with syndromic pathology is shown. On the basis of VEM results types of reaction to physical load for the purpose of revealing of adaptation disturbance of CVS to physical load for a clinical-functional estimation of the remote results of operation for the purpose of definition of the further program of physical rehabilitation at an ambulant and sanatorium stage have been revealed. There are 13 algorithms of children’s prophylactic medical examination with complicated CPH developed, approved and introduced in practice of public health.