Клініко-морфологічні паралелі у патогенезі хронічних запальних процесів внутрішніх статевих органів у жінок з варикозним розширенням вен малого таза

Abstract

Violation of hemomicrocirculatory processes is in the basis of the development of diseases of various organs and systems. The study of hemomicrocirculation at all levels allows us to understand the complexity and universality of these processes, as well as opens up new perspectives in the pathogenetic approach to the treatment and prevention of the diseases. The homogeneity of the reaction of all parts of the hemomicrocirculatory bed in various diseases has been proved on the basis of clinico-morphological comparisons. Study of some areas allows us to judge the state of hemomicrocirculation as an integral system. The objective: to study and compare the changes of the hemomicrocirculatory bed (HMCB) of the conjunctiva of the eyeball and adventitia of varicose veins of the small pelvis (VVSP) in women with chronic inflammatory processes of the internal genital organs (CIPIGO). Materials and methods. There were examined 54 women with chronic inflammatory processes of internal genital organs against the background of varicose veins of the small pelvis (group I); 30 – practically healthy women (control group). The age of women was between 18 and 45 years old. Bulbar microscopy was performed using the SHL-2B slit lamp. The results of microscopy were evaluated according to the system of V.S.Volkov et al. To evaluate the restructuring of the HMCB of adventitia of VVSP, the operating material of 12 women of reproductive age was used. Mainly, these were pieces of the ovarian vein. The study of HMCB in the vein wall was performed by the non-injecting method of silver impregnation according to V.V. Kupriyanov. To standardize the results, the state of the HMCB of venous wall adventitia was studied in norm in 5 women of reproductive age, who died as a result of various injuries. Results. Clinical-morphological parallels between changes in the HMCB of the conjunctiva of the eyeball and adventitia of the varicose veins of the small pelvis were revealed after the performed research. The arteriols’ architectonics was almost unchanged. Venules were dilated, twisted, somewhere varicose-enlarged, filled with formed elements. The structure of capillaries was polymorphic. The capillary net was localized and concentrated or shaped in the form of a thick planar net, the capillaries were expanded. In the micropreparations of the adventitia, there were arterio-venular anastomosis. The nuclei of the endothelial cells were shortened. In some preparations, the diameter of the arterioles corresponded to the diameter of the collection venules. Conclusions. 1. Our studies confirm both clinically and pathomorphologically that one of the links of the pathogenesis of CIPIGO, which occur against the background of VVSP, is a violation of HMCB. 2. Firstly, changes in the HMCB of the conjunctiva of the eyeball and adventitia of the varicose veins of the small pelvis in women with CIPIGO show that they are systemic. 3. The results obtained by us prove the necessity of the use of medicines that improve hemomicrocirculation in the treatment of CIPIGO against the background of VVSP. Key words: hemomicrocirculatory bed, bulbar conjunctiva, adventitia, varicose veins of the small pelvis, chronic inflammatory diseases of the small pelvic organs.