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},
"code": "D18.1",
"name": "Лимфангиома любой локализации",
"icd_name": "Лимфангиома любой локализации",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
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],
"periodicity": 1,
"slug": "d18.1_limfangioma_lyuboy_lokalizacii",
"lead": "доброкачественная опухоль врожденного характера, состоящая из множества тонкостенных кист различных размеров, являющихся формой атипично развитых лимфатических сосудов",
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"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Причины образования лимфангиом у детей в настоящее время научно не доказаны. Предполагают, что основным этиологическим фактором врожденной патологии является внутриутробный порок развития кровеносных и лимфатических сосудов. Неправильное развитие сосудистой ткани, скопление жидкости в лимфатических сосудах приводит к их расширению и превращению в полости. Подтверждают теорию о нарушении эмбриогенеза следующие факты: врожденный характер опухоли, ее сочетание с другими внутриутробными пороками и аномалиями плода.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Другие ученые считают, что лимфангиома – истинная опухоль. Это мнение обусловлено пролиферацией опухолевых клеток и наличием в неоплазии факторов роста. Этот путь образования опухолей наиболее характерен для взрослых пациентов.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Причины вторичных лимфангиом:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Инфекционные болезни,</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Оперативные вмешательства,</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лучевая терапия,</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Другие опухоли.</span></li>\r\n</ul>\r\n<p> </p>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Механизмы развития лимфангиомы изучены недостаточно хорошо. Основным патологическим процессом многие исследователи называют объединение лимфатических цистерн в глубоком подкожном пространстве. Они отделены от нормальной сосудистой сети, но сообщаются с поверхностными капиллярами через вертикальные расширенные каналы. Предположительно, цистерны возникают из примитивного лимфатического мешка, неспособного объединиться с остальной частью лимфатической системы в эмбриогенезе.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Гипертрофированные мышечные волокна, выстилающие секвестрированные участки, поддерживают ритмические сокращения стенки, что приводит к увеличению давления с дилатацией восходящих к коже каналов. Вокруг измененных лимфатических сосудов поверхностных и глубоких отделов дермы происходят процессы фиброза, эпидермис подвергается акантозу, папилло­матозу, гиперкератозу. Некоторые варианты лимфангиом сопровождаются выраженным инфильтратив­ным ростом, но без разрушения тканей.</span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Пренатальная диагностика возможна со II-го триместра беременности. При эхографическом исследовании лимфангиома представлена множественными кистозными образованиями мягких тканей. Отличительным признаком лимфангиомы является отсутствие внутриопухолевого кровотока.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Диагностика лимфангиомы после рождения ребенка не вызывает затруднений по характерной клинической картине.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Очень информативно выполнение МРТ, что позволяет более точно определить анатомическое взаимоотношение опухоли с окружающими тканями, расположение сосудов и нервов.</span></p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Способ коррекции выбирают, опираясь на локализацию лимфангиомы, размеры, глубину залегания, распространение, наличие осложнений. Допустимы следующие варианты:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Склеротерапия. Введение в сосудистую аномалию склерозирующих веществ (блеомицина, пицибанила, этоксисклерола) ведет к сокращению ее размеров. Склеротерапия дает хороший косметический результат, а потому более предпочтительна при поражении шейно-лицевой зоны. Показана перед операцией или при невозможности выполнить полную резекцию.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Радикальное иссечение. При удалении опухолевого очага наиболее целесообразно традиционное хирургическое вмешательство. Радикальную эксцизию считают методом выбора при крупных кавернозных образованиях и необходимости выполнения ургентной операции. Однако удаление глубоких мальформаций сопровождается высоким риском рецидива.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Малоинвазивные методы. Лечение поверхностных лимфангиом может проводиться углекислотным лазером, криотерапией, электрокоагуляцией. Они менее травматичны по сравнению с традиционным иссечением, позволяют сократить сроки реабилитации. Иногда для получения значимого эффекта достаточно всего одной процедуры.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В послеоперационном периоде для оценки полученных результатов и риска рецидива выполняют контрольные исследования. Назначаются нестероидные противовоспалительные, антибактериальные средства, при локализации опухолей на нижних конечностях применяется компрессионная терапия.</span></p>",
"prevention": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Специфическая профилактика данной патологии в настоящее время не разработана. Для предупреждения образования лимфангиом беременным женщинам необходимо следить за здоровьем, не курить, не принимать алкоголь и лекарственные препараты без врачебных назначений, сбалансировано питаться, регулярно посещать женскую консультацию, обследоваться на TORCH-инфекции, принимать специальные витаминные комплексы.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Профилактические мероприятия:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Чтобы предупредить воспаление лимфангиомы, необходимо санировать имеющиеся в организме очаги хронической инфекции — лечить тонзиллит, кариес, отит, гайморит.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">С раннего детского возраста ребенка необходимо приучать к здоровому образу жизни.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Своевременно выявлять и лечить инфекционные и другие заболевания, не допускать развития осложнений.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Повышать иммунитет ребенка: правильно питаться, закаляться, заниматься спортом.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Дети с доброкачественными новообразованиями подлежат обязательному диспансерному учету.</span></li>\r\n</ul>\r\n<p> </p>",
"clinical_picture": "<p><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Клиническая картина определяется локализацией, гистологической структурой, распространением опухоли, анатомо-топографическими особенностями вовлеченных участков, эффективностью проводимого ранее лечения. Ангиоматозные очаги располагаются в любой области, где есть лимфоидная ткань. Часто поражаются лицо (губы, язык, околоушно-жевательная зона), туловище. Но в патологический процесс могут вовлекаться лимфатические узлы, внутренние органы, костная ткань. Развитие опухоли медленное, синхронное с ростом ребенка, в большинстве случаев бессимптомное.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Капиллярная лимфангиома начинается как небольшое постепенно уплотняющееся пятно. Образование имеет нечеткие границы и бугристую поверхность, покрытую мелкими (2–4 мм в диаметре) узелковыми элементами эластичной консистенции, окрашенными в розово-красный цвет. Площадь пораженной кожи со временем расширяется. Иного дискомфорта, кроме эстетического, аномалия обычно не приносит. Иногда из узелковых элементов просачивается лимфа, при травматизации они кровоточат. Увеличиваясь в объеме и приобретая диффузный характер, опухоль давит на подлежащие структуры, что может сопровождаться костными деформациями у детей.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При кистозной или кистозно-кавернозной лимфангиоме лица и шеи наблюдается ограниченная припухлость размером от 3 до 30 см в диаметре, обращенная наружу или в сторону ротовой полости. Кожа над ней обычной окраски или с цианотичным оттенком, растянута, свободна или спаяна с опухолевой массой. Поверхность очага гладкая или бугристая, консистенция мягкая, пальпация безболезненна. Характерен симптом флюктуации.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Особенностью обшир­ных лимфангиом в полости рта, шеи, средостения является периодически возникающее воспаление. Это сопровождается лихорадкой, общей слабостью, появлением локальных симптомов – покраснения, отечности, резкой болезненности пораженной зоны. Воспалительный процесс длится 1–2 недели и постепенно стихает, делая опухоль более плотной.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Интраабдоминальная лимфангиома может давать картину объемного образования, сопровождаясь болью в животе, тошнотой и анорексией, признаками кишечной непроходимости. Симптомы «острого живота» нередко принимают за признак более распространенной хирургической патологии. У некоторых детей отмечают асимметричное увеличение живота с пальпируемой безболезненной опухолью, удовлетворительным общим состоянием. Лимфангиомы малых размеров протекают бессимптомно, выявляясь лишь дополнительными методами.</span></p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
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},
"code": "D18.0",
"name": "Гемангиома любой локализации",
"icd_name": "Гемангиома любой локализации",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
"0"
],
"periodicity": 1,
"slug": "d18.0_gemangioma_lyuboy_lokalizacii",
"lead": "Гемангио́ма ( — доброкачественная опухоль, состоящая из самостоятельно инволюционирующих эндотелиальных клеток",
"description": "<p>Гемангиома появляется у детей как родимое пятно. Такое изменение является результатом порока развития сосудов. Частота обнаружения гемангиом у новорожденных достигает 3%. В 10% проблему выявляют на первом году жизни ребенка. Данные статистики подтверждают, что это самая распространенная доброкачественная опухоль мягких тканей в педиатрии. Частота обнаружения достигает 50% случаев. Проблема в 3-5 раза чаще выявляется у девочек. Гемангиома у взрослых проявляется в исключительных случаях при неполноценном лечении в детском возрасте.</p>\r\n<p> </p>\r\n<p>Доброкачественная опухоль быстро прогрессирует. Она стремительно разрастается на поверхности кожи и в глубину. По мере роста, дефект способен разругать окружающие ткани, приводить к нарушению функций зрения, слуха, дыхания. При травмировании гемангиомы возникает риск инфицирования и образования язвенных деформаций на поверхности.</p>\r\n<p> </p>\r\n<p> </p>",
"etiology": "<p>Точных причин возникновения гемангиом выявить пока не удалось; принято считать, что их появление может спровоцировать нарушение внутриутробного развития плода из-за вирусной болезни матери либо кислородного голодания. Дополнительные факторы риска образования врожденной гемангиомы:</p>\r\n<ul>\r\n<li>многоплодная и/или поздняя беременность;</li>\r\n<li>повышенное количество эстрогена у матери;</li>\r\n<li>ее малоподвижный образ жизни;</li>\r\n<li>несбалансированный рацион;</li>\r\n<li>алкогольная или никотиновая интоксикация плода;</li>\r\n<li>его низкий вес при рождении.</li>\r\n</ul>\r\n<p>У взрослых причиной новообразования могут стать наследственная предрасположенность, заболевания сердечно-сосудистой системы, избыточное ультрафиолетовое облучение, повышенный уровень женских гормонов эстрогенов.</p>",
"pathogenesis": "<p>Гемангиома представляет собой красное пятно, в центре которого расположена точка, а из неё исходит сеть небольших сосудов. Обычно новообразование гладкое, может выступать на 1-2 см над кожей. При нажатии становится бледным, но быстро возвращается к своему обычному виду. Характерный симптом – неравномерность температуры: при пальпации гемангиома заметно теплее окружающих участков тела. Клинически может никак себя не проявлять и обнаруживаться случайно при осмотре.</p>\r\n<p>Заболевание протекает фазами – рост, стабилизация, опционально – спонтанный регресс. В фазах роста и стабилизации гемангиомы возможны осложнения. Если новообразование растет около функционального органа, его работа может ухудшаться – например, в периорбитальной зоне оно может способствовать снижению зрения, а на слизистой гортани – обструкции дыхания.</p>\r\n<p>Если гемангиома локализована около нервного окончания, при ее росте возможны слабость и онемение конечностей, нарушение работы мочевого пузыря и ЖКТ. Крупные гемангиомы позвоночника могут вызывать боль и повышать риск компрессионных переломов. Новообразования легко травмируются, поэтому могут вызывать кровотечения</p>",
"diagnostics": "<div class=\"accordion__content\">\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">Диагностика гемангиомы осуществляется врачом-хирургом с использованием следующих методик:</p>\r\n<ul class=\"list list_unordered b6C6nEQ unit_text_m\">\r\n<li class=\"list__item list__item_paragraph\">Осмотр</li>\r\n<li class=\"list__item list__item_paragraph\">Лабораторная диагностика</li>\r\n<li class=\"list__item list__item_paragraph\">Ультразвуковое исследование (определение глубины распространения опухоли и расчет объема образования; определяются особенности расположения, структура опухоли, измерение скорости кровотока в сосудах).</li>\r\n<li class=\"list__item list__item_paragraph\">Ангиография (обязательна при обследовании больных с обширными и глубокими гемангиомами)</li>\r\n</ul>\r\n</div>",
"treatment": "<p class=\"paragraph b6C6nEQ unit_text_m\">Лечение гемангиом в большинстве случаев необходимо начинать как можно раньше, сразу после постановки диагноза. Наиболее результативно лечение в первые недели и месяцы жизни ребенка.</p>\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">Хирургическое лечение показано при глубоко расположенных сосудистых гемангиомах, когда можно удалить образование целиком, в пределах здоровых тканей, без значительного косметического ущерба. Оперативный метод лечения целесообразно использовать и в тех случаях, когда применение других способов терапии представляется заведомо неэффективным. Успех лечения достигается в 90% случаев. Послеоперационные осложнения редки.</p>\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">Лучевому лечению подлежат гемангиомы сложных месторасположений, в первую очередь таких областей, где другие методы лечения невозможно использовать, например область глазницы. Лучевая терапия показана также при простых гемангиомах большой площади. Облучение проводится отдельными фракциями с интервалами от 2-4 недель до 2-6 месяцев, до исчезновения гемангиомы. Этот метод лечения относительно сложен, и эффект наступает в течение довольно длительного времени.</p>\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">Диатермоэлектрокоагуляции (прижиганию) подлежат лишь небольшие, точечные гемангиомы в тех случаях, когда опухоль располагается в областях, недоступных для другого метода лечения. Электрокоагуляцию обширных и глубоких образований применять не следует. У части больных после электрокоагуляции наблюдаются косметические дефекты.</p>\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">Склерозирующее лечение показано при небольших, глубоко расположенных сосудистых гемангиомах сложного месторасположения, особенно при лечении небольших кавернозных и комбинированных форм на лице и кончике носа. Для инъекций используют 70% спирт. При комбинированных гемангиомах сначала проводится криогенное или СВЧ-криогенное лечение для гибели поверхностной части опухоли, а затем склерозирующая терапия. Недостатками склерозирующей терапии являются болезненность и длительность лечения. Преимущество инъекционной терапии перед другими консервативными методами лечения заключается в ее простоте.</p>\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">Одним из методов лечения обширных гемангиом наружных покровов у детей является гормональное лечение. Оно проводится гормоном <a class=\"link link-like link-like_type_turbo-navigation b9G2sAKE\" href=\"https://yandex.ru/health/pills/product/prednizolon-46443?parent-reqid=1617706803001125-1117516131332047011200135-production-app-host-vla-web-yp-322&utm_source=portal&utm_medium=diseases&utm_campaign=yamd-crosslinks&utm_content=link-from-encyclopedia-to-pills\" data-bem=\"{"link-like":{}}\" data-log-node=\"gjiq\" data-clickable=\"\">преднизолоном</a>. Суточная доза <a class=\"link link-like link-like_type_turbo-navigation b9G2sAKE\" href=\"https://yandex.ru/health/pills/product/prednizolon-46443?parent-reqid=1617706803001125-1117516131332047011200135-production-app-host-vla-web-yp-322&utm_source=portal&utm_medium=diseases&utm_campaign=yamd-crosslinks&utm_content=link-from-encyclopedia-to-pills\" data-bem=\"{"link-like":{}}\" data-log-node=\"gjir\" data-clickable=\"\">преднизолона</a> в таблетках делится на 2 приема: в 6 часов утра ребенок получает 2/3 дозы, в 9 часов утра - 1/3 дозы. Препарат принимается через день без снижения дозировки. Продолжительность курса лечения - 28 дней. При необходимости через 6-8 недель курс лечения повторяют. Данный метод останавливает рост сосудистой опухоли. Долечивание гемангиом после гормонотерапии другими методами позволяет решить косметические проблемы.</p>\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">Широкое применение низкотемпературного воздействия связано с использованием специальных аппаратов и замораживающих систем, что позволяет расширить возможности метода. Благодаря таким важным свойствам, как безболезненность, отсутствие кровотечения и заметной общей реакции организма - криогенный метод широко распространен в лечении гемангиом. Криогенному лечению подлежат все простые гемангиомы небольшой площади, любого расположения и в любом возрасте ребенка. Для лечебного воздействия применяется аппаратный криогенный метод, где в качестве охлаждающего агента используется жидкий азот. Оптимальная продолжительность криовоздействия - 20-25 секунд для гемангиом, располагающихся на коже, и 7-10 секунд для гемангиом, располагающихся на слизистых оболочках. Общая площадь криовоздействия не должна превышать 10 см<sup class=\"sup\">2</sup>.</p>\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">При простых гемангиомах наиболее целесообразно использовать криогенный метод.</p>\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">При лечении простых гемангиом бо</p>\r\n<div class=\"accordion__item accordion__item_expanded b9G2sAKE\" data-bem=\"{"accordion__item":{}}\" data-log-node=\"gjio\">\r\n<div class=\"accordion__content\">\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">льшой площади гормональная и лучевая терапия являются методами выбора.</p>\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">При кавернозных и комбинированных формах наиболее эффективны склерозирующий, хирургический и СВЧ-криогенный методы.</p>\r\n<p class=\"paragraph b6C6nEQ unit_text_m\">При обширных и глубоких гемангиомах околоушной области эффективно комплексное лечение, включающее в себя обязательную ангиографию и эмболизацию гемангиомы.</p>\r\n</div>\r\n</div>",
"prevention": "<p>Гемангиомы могут становиться причиной некроза(омертвения) тканей, поэтому очаг поражения становится входными воротами для инфекции. Присоединение гнойного процесса может стать причиной сепсиса. При гемангиоме костей возможно их разрушение. Кроме этого, процесс может способствовать нарушению свертываемости крови и образованию тромбов. Возможна малигнизация –перерождение гемангиомы в рак. При своевременном обращении к врачу новообразование успешно лечится в 100% случаев<span class=\"info-note\"><a> <br /></a></span></p>",
"clinical_picture": "<p>Существует 2 вида гемангиом – врожденные – сформированные во время внутриутробного развития – и приобретенные; приобретенные в раннем детском возрасте нередко называют младенческими. По структуре различают единичные и множественные гемангиомы (гемангиоматоз), по строению – капиллярные, артериальные и венозные.</p>\r\n<p>По образованию они бывают местными и сегментарными. Местные гемангиомы растут из одной точки, отличаются ровными краями и сравнительно небольшими размерами. Сегментарные – крупные, с «рваным» краем, нередко развиваются в рамках сочетанных патологий грудной клетки, аорты, таза и крестца, пороков сердца и т. д.</p>\r\n<p>По локализации выделяют гемангиомы:</p>\r\n<ul>\r\n<li>простую – образована на поверхности кожи;</li>\r\n<li>кавернозную– растет под кожей;</li>\r\n<li>комбинированную– в процесс вовлечены поверхностные и глубокие слои дермы;</li>\r\n<li>смешанную– в процесс вовлечены не только дермальные, но также нервные и мышечные ткани.</li>\r\n</ul>\r\n<h2 id=\"ank3\"> </h2>",
"image": "http://api.symptomd.ru/storage/gemangioma.jpg",
"image_alt": "Младенческая гемангиома",
"standard_type": 0,
"danger": 1,
"published": 1,
"parent": 8011,
"block_rubric": 37,
"standards": []
}
]
}
