ОBJECTIVE METHOD SELECTION OF CHILDREN WITH INFANTILE HEMANGIOMAS FOR TREATMENT BY LASER RADIATION AND EVALUATION OF EFFECTIVENESS

Infantile hemangiomas, the most common neonatal tumors, are characterized by rapid proliferation which induces various complications. The goal of the study is to develop an algorithm for selection of patients for the treatment of with laser radiation the basis of study characteristics of the infantile hemangiomas with the help non-invasive methods and evaluation of effectiveness carried out by the therapy. Materials and methods. A prospective study of 122 children with infantile hemangiomas aged 1 to 24 months was performed, including assessment of hemangiomas clinical picture, distribution of hemangiomas according to their localization and size, erythemometry and ultrasound scanning. Superficial hemangiomas were detected by Doppler ultrasound in 84 patients (63.6%), combined ones - in 38 patients (28.8%). Findings of hemangioma erythemometry before the course of treatment ranged from 180 to 450 standard units. Results. In 122 children 132 vascular tumors were detected. An algorithm for selection of patients for infantile hemangioma treatment was developed taking into account objective non-invasive methods of ultrasound and skin erythemometry. 2 patients clinical follow-up is recommended, 10 patient is sent for further surgical treatment. The course of treatment is short (1-5 sessions) for 81 patients with superficial hemangiomas. The course of treatment is long (6-10 sessions) for 81 patients with combined hemangiomas Nd:YAP/KTP Q-Sw laser with 3 mm nozzle, radiation wavelength 1079/540 nm was used. Ultrasound examination of all superficially located hemangiomas after the course of laser therapy didn’t show vascular formation and blood flow, the structure of the dermis and hypoderm did not have structural changes in the study. Erythemometry values after treatment to fit the values of the control skin area and 110 - 85 standard units are decreased. Conclusion. An algorithm for selecting patients for Nd: YAP / KTPQ-Sw 1079/540 nm laser treatment was developed including erythemometry, involvement area, depth of involvement, feeding vessel diameter and exclusion of dangerous anatomical localizations.