Konoplitskyi D. Modern approaches to diagnosis and treatment of children with hemangiomas

The research is based on the results of a retrospective and prospective analysis of the treatment of 602 patients of different ages and gender, which comprised altogether 854 foсi of hemangiomas of different localization. Live tissues of experimental animals (combs of roosters and liver) were used to study the mechanism of development of vascular tumors and search for new methods of treatment, which in their structure of the vascular bed and thermophysiological properties correspond to the structure of HA of the skin at children. Obtained indicators of the dynamics of HFZ proteins indicate that the maximum destructive effect on the HA tissue after the injection of triamcenolone and betamethasone occurs within the first 7 days, with a gradual decreasing in the distinction of effective action up to the 21 day. Minimally invasive treatment of HA by intratumoral administration of triamcenolone and betamethasone allows to achieve satisfactory cosmetic and functional results in 95.73 %, which allows to consider it as an alternative to surgical excision of the tumor. Taking into account the defined criteria for inclusion of patients in the group of children for the propranol therapy, 129 children were included, in 65.4 % of the localization of tumors were in aesthetically important areas of the head, neck, critical areas and at the location of HA on the visceral organs. On the basis of the obtained data, a diagnostic - therapeutic algorithm for the treatment of HA at children was elaborated. During the comparison of the vascular parameters between patients who were administered triacenolone and betamethasone intratumoral (group I) and patients who received propranolone (group II) as a treatment measure, was found that in 1, 3, 6 months after the start of treatment that there was a decrease HA blood flow in 1 month after the start of treatment was determined in both comparison groups, but as in 1 month and so in 3 and 6 months more marked changes were observed in group I, patients whose intratumoral injections were TC and BM. Therefore, the presence of HA in a child is a necessary condition for making one of the following important decisions: choosing a patient management tactic (observe - treat); determination of indications before the beginning of therapy; choice of treatment method. The use of the offered diagnostic-therapeutic algorithm of HA allowed 586 (97.34 %) patients to achieve good and satisfactory oncological, functional and cosmetic results of treatment.