ПАТОФИЗИОЛОГИЯ И ПАТОМОРФОЛОГИЯ УШИБОВ ЛЕГКИХ ПРИ ЗАКРЫТОЙ ТУПОЙ ТРАВМЕ ГРУДНОЙ КЛЕТКИ
Ключевые слова:
: грудная клетка, закрытая травма, ушиб легких, патофизиология, патоморфология, диагностика, механизм, танатогенез.Аннотация
The aim of this study is to identify the pathophysiological and pathomorphological manifestations of pulmonary contusions resulting from blunt closed chest trauma. A review and analysis of recent scientific literature on the subject was conducted. Data were obtained from scholarly articles found in MEDLINE and Web of Science through the collection of references, quotations, and statistical data relevant to the topic. In the pathophysiology of pulmonary contusion, the primary role is attributed to the disruption of the blood–air barrier, leading to the leakage of blood and interstitial fluid into the alveolar and interstitial spaces. This results in impaired ventilation and perfusion function of the lungs. The morphological classification of pulmonary contusions distinguishes between localized and extensive forms. A localized contusion is defined as parenchymal damage up to 10 cm in diameter and limited to a single lobe, whereas an extensive contusion involves damage affecting more than one lobe. The main causes of respiratory dysfunction in patients with chest trauma accompanied by pulmonary contusion include: alveolar hypoventilation, ventilation-perfusion mismatch, intrapulmonary right-to-left shunting, and diffusion impairment within the lungs. Further investigation into the pathomorphology of the lungs in closed chest trauma is essential for understanding the pathogenesis of pulmonary complications, which will undoubtedly improve treatment outcomes for patients with pulmonary contusions. Determining the volume and severity of the contusion is also crucial for the objective forensic-medical assessment of injury severity.
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