Vivcharuk V. Optimization of treatment tactics for hemangiomas in children based on predicting the clinical course

The thesis is devoted to the development of methods for improving the cosmetic and functional results of the treatment of superficial hemangiomas in children by individualizing the choice of conservative and surgical methods of treatment based on predicting its outcome. An examination of 100 children with external hemangiomas, who received treatment at the Health Care Municipal Enterprise Regional Children Clinical Hospital No. 1 in Kharkiv in 2017 – 2019, 15 practically healthy children, who were registered in the Municipal Non-Commercial Enterprise «City Children's Polyclinic No. 14» of Kharkiv City Council, in 2020 was carried out, and 147 hospital records of inpatients who were treated for hemangiomas at the Health Care Municipal Enterprise Regional Children Clinical Hospital No. 1 in Kharkiv for the period from 2010 to 2012 were studied. The peculiarities of morphological, clinical, laboratory and functional parameters in patients with hemangiomas were studied, taking into account the age, sex, term of its occurrence and treatment onset. The values of apoptosis markers of serum forms Fas and FasL in practically healthy children and children with hemangiomas of different morphological types before and after treatment were established. The system of assessment of the clinical course of hemangiomas of external localization in children using several scales was adapted. The surgical technology for treating large hemangiomas by implanting a silicone expander under the tumor was developed. The use of high-frequency coagulation and biological tissue electric welding during surgical interventions for hemangiomas was proposed. We developed a method of local conservative treatment with a combination of intratumoral administration of corticosteroids and surface application of β-blockers on hemangioma with permanent compression. The application of local treatment with the use of surface application of β-blockers on hemangiomas and permanent compression was proposed. The clinical effectiveness of the applied methods of treatment was proved. At the beginning of hemangioma treatment at the age of up to 2 months, the cosmetic effect significantly increases in comparison with the results of treatment started in later terms. Significant indicators for predicting the effectiveness of hemangioma treatment were identified. A doctor's support decision-making system was developed which allows the doctor to individually choose the optimal method and duration of treatment and predict the outcome of treatment at the stage of his choice.