FEATURES OF HISTOMORPHOLOGICAL CHANGES IDENTIFIED IN POST-TRAUMATIC PERICARDITIS

Resume. Introduction. Despite the use of modern methods of diagnos dcis and treatment, combat trauma of the chest organs during hostilities is the most common cause of severe complications and mortality among the wounded and injured. Therefore, the problem of diagnosing traumatic injuries of the OGK and their complications during hostilities remains relevant. In works devoted to the study of the morphological picture of pericarditis, the features of the course of inflammation in the pericardial sheets, the possibility of its spread to tissues adjacent to the pericardium are not fully reflected. Purpose of the study. To analyze the features of morphological changes in post-traumatic inflammation of the pericardium on the basis of histomorphological examination of surgical material obtained during pericardectomy. Material and methods of the study. The work, which was conducted at the State Institution «V. T. Zaitsev Institute of Pericardial Diseases of the National Academy of Medical Sciences of Ukraine», presents the results of histomorphological studies in 96 wounded and injured people with post-traumatic pericarditis due to combat trauma. The average age of the injured men is (51.4 ± 1.52) years, women — (55.3 ± 1.49) years. We analyzed the morphological material, which is represented by fragments of the pericardium, myocardium and epicardium obtained during partial or subtotal pericardectomy operations. Statistical analysis of the obtained results was carried out using the standard package of application programs Microsoft Office Excel 2010 and StatSoft Statistica 6.0. Results of the study. In order to analyze the dependence of inflammatory changes in the pericardium on the localization and severity of the injury, as well as to identify inflammatory changes in the pericardial sheets, a study of morphological material was conducted. Pericardial surgery provides a unique opportunity to obtain tissue and fluid samples for diagnostic studies. The results of morphological analysis of surgical material showed that in the vast majority of cases (27-92.6%) the morphological picture of pericarditis was nonspecific and depended on the state of the course of developed tissue inflammation, cellular infiltration and vascular reaction. Morphological changes indicated a wave-like course of inflammation in the serous membrane of the heart: at the same time, calcification was present in the preparations, as evidence of completed inflammation, and morphological signs of active and fading inflammation of the pericardium and epicardium, and this combination was observed in more than half (56.3%) of cases. Conclusions. Based on the analysis of the morphological picture of constrictive pericarditis, it was found that in 70.3% of cases, a recurrent or fading inflammatory process is observed. The role of adipose tissue in prolonging productive inflammation of the pericardial sheets was additionally revealed. Also, pronounced degenerative changes in the nerve conductors and the receptor apparatus of the pericardium were detected, which are of decisive importance in functional disorders in the heart.