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犬环咽肌吞咽困难的手术治疗:14例(1989 - 2001年)

Surgical management of cricopharyngeal dysphagia in dogs: 14 cases (1989-2001).

作者信息

Warnock Jennifer J, Marks Stanley L, Pollard Rachel, Kyles Andrew E, Davidson Autumn

机构信息

Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

出版信息

J Am Vet Med Assoc. 2003 Nov 15;223(10):1462-8. doi: 10.2460/javma.2003.223.1462.

Abstract

OBJECTIVE

To determine outcome of and complications associated with cricopharyngeal myotomy or myectomy for treatment of cricopharyngeal dysphagia (CPD) in dogs.

DESIGN

Retrospective study.

ANIMALS

14 dogs.

PROCEDURE

Medical records of dogs with CPD that underwent cricopharyngeal myotomy or myectomy were examined. Follow-up information was obtained through telephone interviews with owners and referring veterinarians and clinical examinations when feasible.

RESULTS

16 surgical procedures were performed on the 14 dogs. Dysphagia was completely resolved immediately after surgery in 1 dog, and clinical signs did not recur (follow-up time of 8 years); a second dog also had immediate complete resolution of dysphagia, but follow-up time was only 10 days. Three dogs had transient complete resolution with a mean time to recurrence of dysphagia of 12.3 weeks (range, 2 to 36 weeks). Three dogs had permanent partial resolution. Six dogs had no improvement after surgery. Eight of the 14 dogs were euthanatized because of problems related to CPD, including persistent dysphagia (n = 8) and aspiration pneumonia (5).

CONCLUSIONS AND CLINICAL RELEVANCE

The failure rate for dogs undergoing surgical treatment of CPD may be high, particularly if concurrent aspiration pneumonia or malnutrition is not addressed prior to surgery. For those dogs with concurrent diseases, more aggressive medical management, such as enteral tube feeding, may be warranted rather than surgery. In dogs with CPD complicated by other anatomic or functional conditions, such as myasthenia gravis, laryngeal paralysis, and esophageal stricture, surgery may also not be indicated.

摘要

目的

确定环咽肌切开术或切除术治疗犬环咽肌吞咽困难(CPD)的疗效及相关并发症。

设计

回顾性研究。

动物

14只犬。

方法

检查接受环咽肌切开术或切除术的CPD犬的病历。通过与犬主和转诊兽医电话访谈获取随访信息,并在可行时进行临床检查。

结果

对14只犬实施了16次手术。1只犬术后吞咽困难立即完全缓解,且临床症状未复发(随访8年);另1只犬吞咽困难也立即完全缓解,但随访时间仅10天。3只犬吞咽困难短暂完全缓解,吞咽困难复发的平均时间为12.3周(范围2至36周)。3只犬永久部分缓解。6只犬术后无改善。14只犬中有8只因与CPD相关的问题实施安乐死,包括持续性吞咽困难(8只)和吸入性肺炎(5只)。

结论及临床意义

接受CPD手术治疗的犬失败率可能较高,尤其是术前未解决并发的吸入性肺炎或营养不良问题时。对于那些患有并发疾病的犬,可能需要更积极的内科治疗,如肠内管饲,而非手术治疗。对于并发其他解剖或功能异常的CPD犬,如重症肌无力、喉麻痹和食管狭窄,也可能不建议手术治疗。

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