Hunt Geraldine B, Kummeling Anne, Tisdall Penelope L C, Marchevsky Andrew M, Liptak Julius M, Youmans K Ruth, Goldsmid Sarah E, Beck Jason A
Veterinary Cardiovascular Unit, Faculty of Veterinary Science, University of Sydney, Sydney, Australia.
Vet Surg. 2004 Jan-Feb;33(1):25-31. doi: 10.1111/j.1532-950x.2004.04011.x.
To report outcomes after cellophane banding of single congenital portosystemic shunts in dogs and cats.
Retrospective study of sequential cases.
One hundred and six dogs and five cats.
Medical records were reviewed for breed, sex, age at surgery, shunt anatomy, results of pre- and postoperative biochemical analysis, development of postligation neurologic dysfunction, portal hypertension or other serious complications, and the owners' perception of their animal's response to surgery.
Ninety-five dogs and all 5 cats had extrahepatic shunts. Eleven dogs had intrahepatic shunts. Six dogs (5.5%) died as a result of surgery from portal hypertension (2 dogs), postligation neurologic dysfunction (2), splenic hemorrhage (1) and suspected narcotic overdose (1). Serious complications were more common in dogs with intrahepatic shunts than those with extrahepatic shunts (P=.002). Postligation neurologic dysfunction necessitated treatment in 10 dogs and 1 cat; 8 dogs and the cat survived. Clinical signs attributed to portosystemic shunting resolved or were substantially attenuated in all survivors. Postoperative serum bile acid concentrations or results of ammonia tolerance testing were available for 88 animals; 74 (84%) were normal and 14 (16%) were abnormal. Multiple acquired shunts were documented in two animals.
Cellophane banding is a safe and effective alternative to other methods of attenuation.
Slow occlusion of portosystemic shunts using a variety of methods is being evaluated world wide. Cellophane banding is a relatively simple procedure with comparable safety and efficacy to previously reported techniques.
报告犬猫先天性单一门体分流的玻璃纸包扎术后的结果。
对连续病例的回顾性研究。
106只犬和5只猫。
查阅病历,了解品种、性别、手术时年龄、分流解剖结构、术前和术后生化分析结果、结扎后神经功能障碍、门静脉高压或其他严重并发症的发生情况,以及主人对其动物手术反应的看法。
95只犬和所有5只猫有肝外分流。11只犬有肝内分流。6只犬(5.5%)因手术死亡,原因包括门静脉高压(2只)、结扎后神经功能障碍(2只)、脾出血(1只)和疑似麻醉过量(1只)。肝内分流的犬比肝外分流的犬严重并发症更常见(P = 0.002)。10只犬和1只猫因结扎后神经功能障碍需要治疗;8只犬和这只猫存活。所有存活动物中,门体分流引起的临床症状得到缓解或明显减轻。88只动物有术后血清胆汁酸浓度或氨耐受试验结果;74只(84%)正常,14只(16%)异常。两只动物记录有多发性后天分流。
玻璃纸包扎是其他减流方法的一种安全有效的替代方法。
世界各地正在评估使用多种方法缓慢闭塞门体分流。玻璃纸包扎是一种相对简单的手术,其安全性和有效性与先前报道的技术相当。