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保守治疗或手术治疗猫腹膜心包膈疝的长期预后:66例(1987 - 2002年)

Long-term outcome of cats treated conservatively or surgically for peritoneopericardial diaphragmatic hernia: 66 cases (1987-2002).

作者信息

Reimer S Brent, Kyles Andrew E, Filipowicz Dean E, Gregory Clare R

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. 2004 Mar 1;224(5):728-32. doi: 10.2460/javma.2004.224.728.

Abstract

OBJECTIVE

To determine long-term outcome of cats treated conservatively or surgically for peritoneopericardial diaphragmatic hernia (PPDH).

DESIGN

Retrospective study.

ANIMALS

67 cats with PPDH.

PROCEDURE

Medical records of cats with a diagnosis of PPDH made from 1987 through 2002 were reviewed. Information regarding long-term outcome was obtained from owners.

RESULTS

Prevalences of PPDH in domestic longhair and Himalayan cats were significantly greater and prevalence of PPDH in domestic shorthair cats was significantly lower than prevalence of PPDH in the hospital cat population over the 15-year study period. Historical problems most commonly related to the respiratory and gastrointestinal tracts. Peritoneopericardial diaphragmatic hernia was the primary diagnosis in 40 cats and an incidental finding in 27 cats. One cat died prior to arrival at the Veterinary Medical Teaching Hospital. Thirty-seven of 66 cats were treated surgically, and 29 were treated conservatively. The postoperative mortality rate was 14%. Postoperative complications developed in 29 of 37 cats, the most common of which was hyperthermia. Two of 22 conservatively treated cats had progression of clinical signs necessitating surgical intervention or resulting in death. Owner satisfaction with treatment choice and long-term outcome was rated as very satisfied by 88% of owners of surgically treated cats and 68% of owners of conservatively treated cats.

CONCLUSIONS AND CLINICAL RELEVANCE

Cats with overt clinical signs attributable to PPDH are good candidates for surgical herniorrhaphy. Postoperative complications may develop but are generally minor and self-limiting. Long-term outcome of cats treated conservatively or surgically was rated as very good by most owners.

摘要

目的

确定接受保守治疗或手术治疗的猫腹膜心包膈疝(PPDH)的长期预后。

设计

回顾性研究。

动物

67只患有PPDH的猫。

方法

回顾1987年至2002年诊断为PPDH的猫的病历。从猫主人处获取有关长期预后的信息。

结果

在15年的研究期内,家养长毛猫和喜马拉雅猫中PPDH的患病率显著高于医院猫群,而家养短毛猫中PPDH的患病率显著低于医院猫群。历史问题最常与呼吸道和胃肠道有关。40只猫的主要诊断为腹膜心包膈疝,27只猫为偶然发现。1只猫在到达兽医教学医院之前死亡。66只猫中有37只接受了手术治疗,29只接受了保守治疗。术后死亡率为14%。37只接受手术治疗的猫中有29只出现术后并发症,最常见的是体温过高。22只接受保守治疗的猫中有2只临床症状进展,需要手术干预或导致死亡。88%接受手术治疗的猫的主人和68%接受保守治疗的猫的主人对治疗选择和长期预后的满意度评价为非常满意。

结论及临床意义

有明显临床症状的PPDH猫是手术修补疝的良好候选者。术后可能会出现并发症,但一般较轻且为自限性。大多数主人对接受保守治疗或手术治疗的猫的长期预后评价为非常好。

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