Stephen Jennifer O, Corley Kevin T T, Johnston Janet K, Pfeiffer Dirk
New Bolton Center, University of Pennsylvania, Kennett Square, PA, USA.
Vet Surg. 2004 Jul-Aug;33(4):340-8. doi: 10.1111/j.1532-950X.2004.04049.x.
To determine historical, physical, and clinical factors that may affect morbidity and mortality in horses with small intestinal volvulus unrelated to other causes (e.g., incarceration, lipoma, etc.).
Retrospective study.
Client-owned horses (115), aged 1 month to 21 years.
Data were obtained from medical records, identified by computer search and manual review. Continuous variables were compared between affected and non-affected horses with Mann-Whitney U-tests and non-continuous variables with Fisher's exact test (2 x 2 tables) or chi(2)-tests (larger tables). Stepwise logistic regression analysis was used to develop a multivariable model of the risk factors, taking account of confounding and interaction.
Eighty percent of horses recovered from surgery survived to hospital discharge. Neither age, breed, nor sex was related to mortality. Survivors had a significantly lower heart rate, shorter capillary refill time, and better mucous membrane color. Variables associated with worsening cardiovascular status, increased hemoconcentration, and exudation of cells and protein into peritoneal fluid were significantly associated with non-survival. After recovery from surgery, the most serious complication was colic, which was significantly associated with non-survival (P=.028) as was a second celiotomy (P<.01). Both of these complications were associated with a jejunocecostomy during the first surgery.
Significant differences in the clinical and clinicopathologic signs were identified between survivors and non-survivors.
These findings can be used to make a scientific assessment of prognosis in the pre-operative, operative, and post-operative management of horses with small intestinal volvulus.
确定可能影响无其他病因（如肠嵌闭、脂肪瘤等）的小肠扭转马匹发病率和死亡率的病史、体格检查及临床因素。
回顾性研究。
客户拥有的马匹（115匹），年龄1个月至21岁。
数据从病历中获取，通过计算机检索和人工查阅确定。采用曼-惠特尼U检验比较患马和未患马的连续变量，采用费舍尔精确检验（2×2表格）或卡方检验（更大表格）比较非连续变量。采用逐步逻辑回归分析建立风险因素的多变量模型，同时考虑混杂因素和相互作用。
80%接受手术的马匹术后存活至出院。年龄、品种和性别均与死亡率无关。存活马匹的心率显著较低、毛细血管再充盈时间较短且黏膜颜色较好。与心血管状况恶化、血液浓缩增加以及细胞和蛋白质渗入腹腔液相关的变量与死亡显著相关。术后恢复过程中，最严重的并发症是腹痛，其与死亡显著相关（P = 0.028），再次剖腹术也是如此（P < 0.01）。这两种并发症均与首次手术时的空肠回肠吻合术有关。
存活者与非存活者在临床和临床病理体征方面存在显著差异。
这些发现可用于对小肠扭转马匹术前、术中和术后管理中的预后进行科学评估。
