PATHOMORPHOLOGICAL CHARACTERISTICS OF DETECTOR DAMAGE IN NEWBORNS WIHT ENTROCOLITES OF DIFFERENT ETIOLOGIES
| Autor: | O. V. Vorobiova, T. K. Znamenska, T. M. Klimenko |
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| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Neonatology, surgery and perinatal medicine. 8:25-33 |
| ISSN: | 2413-4260 2226-1230 |
| Popis: | Pathomorphologically NEC is characterized by inflammation and severe tissue damage. To complete the understanding of all pathogenic mechanisms in the work, an objective morphological analysis of the state of inter-tissue relations in the small intestine wall with the NEC was conducted. The elucidation of the leading pathogenetic mechanisms that determine the prevalence and progression of degradation in the ineffectiveness of protective inflammatory response both to the child's body as a whole and to the intestinal wall of the NEC will allow the development of a system of criteria for early diagnosis and prevention of NEC development.The aims. Clarify the morphogenesis of the NEC, conduct an immunohistochemical study and morphological analysis of the state of inter-tissue relations in the small intestine wall at the NEC in premature infants compared with bacterial enterocolitis.Materials and methods of research. Morphological and immunohistochemical research presents the material of the small intestine of infants born from enterocolitis (sepsis) and NEC - 18 autopsy and 7 intraoperative materials: 7 preparations with a stage of preperforation, 9 with a stage of perforation. To objectivize pathomorphological changes in the intestine, a comparison was made with infectious enterocolitis (5 autopsies). An assessment was made of the condition of the small intestine wall obtained during perforation operations (border zone and adjacent organ region). Controls were cuttings of the healthy small intestine of preterm infants whose death came from non-infection-related causes and NECs (4 cases).Results of the research. Pathological changes in the NEC affect all the walls of the small intestine. Clinically in preterm newborns the disease is characterized by progression of both generalized symptoms and gastrointestinal ones against the background of the systemic inflammatory response. The leading pathomorphological process is the change in the quantitative morphological parameters of the vascular bed, the development of severe edema with the dissociation of inter-tissue relations and the marked destruction of structural elements of the intestinal wall. In this case, the inflammatory-reparative process is characterized by the prevalence of alteration in the inadequate response of leukocytes to the degree of destruction and reduction of the reparative potential of tissue elements of the gut mucosa. This determines the persistent violation of its barrier function, reducing the resistance to action of microbial agents and progressive damage. The leading pathogenetic mechanisms determine the prevalence and progression of degradation in the ineffectiveness of protective inflammatory response both in the child's body and in the intestinal wall at the NEC. |
| Databáze: | OpenAIRE |
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