Minihan Anne C, Berg John, Evans Krista L
School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts 01536, USA.
J Am Anim Hosp Assoc. 2004 Jan-Feb;40(1):51-63. doi: 10.5326/0400051.
Medical records of 34 dogs and 16 cats undergoing surgical repair of diaphragmatic hernia of >2 weeks' duration were reviewed, and long-term follow-up information was obtained. The most common clinical signs were dyspnea and vomiting; however, many of the animals were presented for nonspecific signs such as anorexia, lethargy, and weight loss. Thoracic radiographs revealed evidence of diaphragmatic hernia in only 66% of the animals, and additional imaging tests were often needed to confirm the diagnosis. Thirty-six hernias were repaired through a midline laparotomy; 14 required a median sternotomy combined with a laparotomy. In 14 animals, division of mature adhesions of the lungs or diaphragm to the herniated organs was necessary to permit reduction of the hernia. Fourteen animals required resection of portions of the lungs, liver, or intestine. All hernias were sutured primarily without the use of tissue flaps or mesh implants. Twenty-one of the animals developed transient complications in the postoperative period; the most common of these was pneumothorax. The mortality rate was 14%. Thirty-four (79%) of the animals that were discharged from the hospital had complete resolution of clinical signs, and none developed evidence of recurrent diaphragmatic hernia during the follow-up period. Nine were lost to follow-up.
对34只犬和16只猫的病历进行了回顾，这些动物均接受了病程超过2周的膈疝手术修复，并获得了长期随访信息。最常见的临床症状是呼吸困难和呕吐；然而，许多动物表现出非特异性症状，如厌食、嗜睡和体重减轻。胸部X光片仅在66%的动物中显示有膈疝迹象，通常需要额外的影像学检查来确诊。36例疝通过中线剖腹术修复；14例需要正中胸骨切开术联合剖腹术。14只动物需要分离肺或膈肌与疝入器官的成熟粘连，以还纳疝。14只动物需要切除部分肺、肝或肠。所有疝均采用一期缝合，未使用组织瓣或网状植入物。21只动物在术后出现短暂并发症；其中最常见的是气胸。死亡率为14%。出院的动物中有34只（79%）临床症状完全消失，随访期间均未出现复发性膈疝迹象。9只失访。
