Морфометрическая характеристика изменений в кровеносном русле печени при сочетанной травме грудной клетки и бедра

Abstract

Background: The frequency of associated injuries of the chest and musculoskeletal has a tendency to increase. Combined trauma mortality is by more than three times higher than the the rate of mortality of other trauma patients. The aggregate deviation often leads to the development of multiorgan failure. In particular, hepatocellular disorders arise from disorders of the microcirculation and appear already at reducing the circulating blood volume by 10%. Therefore the aim of the study was to determine the morphological features and give morphometric characterization of the dynamics of remodeling of blood vessels in the liver associated trauma of the chest and hips in the experiment. Material and methods: Experiments were carried out on white rats, which were divided into two groups: control and experimental. Animals of the experimental group were modeled with left-sided pneumothorax closed rib fracture and combined with a closed fracture of the left femur. Material for histologic and morphometric studies were taken on 1, 3 , 7, 14 and 28 days. Results: The study found that in response to the application of combined injuries of the chest and hips in the early posttraumatic period arterial bloodstream of the liver reacts by narrowing of the arteries, arterioles with a reduction in their capacity as a manifestation of veno- arterial reflex reaction of Kitaev arising in response to the plethora of stagnant. On the third day of observation vasoconstriction potentiated by hypoxia, naturally occurring in the trauma of the chest, was accompanied by pneumothorax with atelectasis. These vascular responses have achieved their maximum degree on the 7th day of the experiment. This was followed by regression of them and by the 28th day the state of the blood vascular bed of the liver approached to the original level. Conclusions: Combined trauma provoke significant disturbancies in liver bloodstream, that, in early posttraumatic period, are characterized by ascendant constriction, narrowing of the lumen and thickening of the wall of large and intermediate sized arteries.