Abstract
The progressive course of diseases of the veins of the lower extremities leads to the development of complications in more than 80% of patients with post-thrombotic disease. Purpose of the work: to study the morphometric features of remodeling of the venous bed of the extremities in experimental trophic ulcer and its correction. A complex of morphological methods was used to examine the veins of the lover limbs of 18 adult male Vietnamese pigs, which were divided into 3 groups. 1 group consisted of 6 intact practically healthy animals, the 2 group – 6 pigs with simulated trophic ulcer, the 3 group – 6 animals with Lidocaine-corrected ulcer. The area of the trophic ulcer was measured. The trophic ulcer was taken together with the surrounding tissues, from which histological micropreparations were made, which determined the diameters of capillary venules, venules, outer and inner diameters of venous vessels, the height of endothelial cells, the diameter of their nuclei, nuclear-cytoplasmic ratios in these cells, volume of damaged endotheliocytes. A correlation analysis was performed between the ulcer area and morphometric parameters. Quantitative values were processed statistically. Strong positive correlations have been established between nuclear-cytoplasmic relation in endothelial cells, the relative volume of damaged endotheliocytes, and the area of the ulcer defect (r=+0,84±0,03), at correction of an ulcer by Lidocaine they weakened a little. It was found that the correction of trophic ulcers with Lidocaine led to a decrease in its area by 25.8%. It is established that the experimental trophic ulcer leads to pronounced remodeling of the venous bed of the lower extremities, which is characterized by significant dilation of venous vessels, venous plethora complicated by hypoxia, atrophic, dystrophic, necrobiotic, infiltrative processes and sclerosis. The use of Lidocaine in experimental trophic ulcer improves the adaptive-compensatory and regenerative processes of the modeled pathology, reduces the relative volume of damaged endothelial cells in the venous vessels of the lower extremity by 18.8% (p<0.001).
Highlights
Chronic venous insufficiency is a symptom complex that characterizes a condition caused by venous disease, in particular, varicose veins, postthrombotic disease or venous angiodysplasia, caused by the presence of venous hypertension, the clinical signs of which are heaviness, fatigue of the lower extremities, edema, edema, flatulence. pain, telangiectasia, varicose veins, trophic disorders and ulcers [24]
It is established that the experimental trophic ulcer leads to pronounced remodeling of the venous bed of the lower extremities, which is characterized by significant dilation of venous vessels, venous plethora complicated by hypoxia, atrophic, dystrophic, necrobiotic, infiltrative processes and sclerosis
The diameters of capillary venules (DCV), venules (DV), external (EDVV) and internal (IDVV) diameters of venous vessels, height of endotheliocytes (HE), diameter of their nuclei (DN), nuclearcytoplasmic relations (NCR) were determined, the relative volume of damaged endotheliocytes (RVDE) [1, 27]. 50 measurements were performed on each micropreparation
Summary
Chronic venous insufficiency is a symptom complex that characterizes a condition caused by venous disease, in particular, varicose veins, postthrombotic disease or venous angiodysplasia, caused by the presence of venous hypertension, the clinical signs of which are heaviness, fatigue of the lower extremities, edema, edema, flatulence. pain, telangiectasia, varicose veins, trophic disorders and ulcers [24]. Trophic ulcers of the lower extremities are found in almost every fifth patient with CVI, they often recur and cause a deterioration in quality of life [7]. Trophic ulcers among the world's population are found in 0.2% of patients with varicose veins under the age of 50 years and in 2.6% - over 50 years. Valve failure of the venous system of the lower extremities leads to the formation of persistent phlebohypertension, which progresses rapidly, causing pathogenetic and destructive changes in the soft tissues of the lower extremities. Despite significant advances in diagnosis and treatment in recent years, the choice of pathogenetic treatment in patients with severe chronic venous insufficiency remains controversial and unresolved. The development of irreversible trophic changes in the soft tissues of the lower extremities in most patients leads to no effect from treatment
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