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300 匹接受急腹症手术治疗马匹的存活率及并发症发生率。第3部分:远期并发症及存活率

Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 3: Long-term complications and survival.

作者信息

Mair T S, Smith L J

机构信息

Bell Equine Veterinary Clinic, Mereworth, Maidstone, Kent ME18 5GS, UK.

出版信息

Equine Vet J. 2005 Jul;37(4):310-4. doi: 10.2746/0425164054529445.

Abstract

REASONS FOR PERFORMING STUDY

Few studies have evaluated long-term survival and complication rates in horses following surgical treatment of colic, making it difficult to offer realistic advice concerning long-term prognosis.

OBJECTIVE

To review the complications occurring after discharge from hospital and survival to >12 months after surgery of 300 horses undergoing exploratory laparotomy for acute colic. Pre-, intra- and post operative factors that affected long-term complications and long-term survival were assessed.

METHODS

History, clinical findings, surgical findings and procedures and post operative treatments of 300 consecutive surgical colic cases (1994-2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners.

RESULTS

The long-term (>12 months) survival rate for 204 horses discharged after colic surgery and for which follow-up information was available was 84%. The most common complication after discharge was colic, affecting 35.1% of horses following a single laparotomy. Colic was most common in horses that had had small intestinal obstructions, bowel resection or post operative ileus. Abdominal adhesions were most common in horses that presented with severe colic due to strangulation of small intestine. Ventral hernia formation occurred in 8% of horses, and was most common in horses that had had post operative wound drainage or infection.

CONCLUSIONS

This study identified various factors that appear to predispose horses to long-term complications after colic surgery.

POTENTIAL RELEVANCE

Further evaluation of strategies that might reduce the incidence of such complications are needed; in particular, the value of intraperitoneal heparin should be evaluated, and procedures designed to reduce the rates of wound drainage and infection assessed.

摘要

开展本研究的原因

很少有研究评估马匹结肠绞痛手术治疗后的长期存活率和并发症发生率,因此难以就长期预后提供切实可行的建议。

目的

回顾300匹因急性结肠绞痛接受剖腹探查术的马匹出院后发生的并发症以及术后存活超过12个月的情况。评估影响长期并发症和长期存活的术前、术中和术后因素。

方法

回顾了300例连续的手术治疗结肠绞痛病例(1994 - 2001年)的病史、临床检查结果、手术发现及操作和术后治疗情况。从病例记录和对马主的电话询问中获取长期随访信息。

结果

204匹结肠绞痛手术后出院且有随访信息的马匹的长期(>12个月)存活率为84%。出院后最常见的并发症是结肠绞痛,在单次剖腹手术后影响了35.1%的马匹。结肠绞痛在患有小肠梗阻、肠切除或术后肠梗阻的马匹中最为常见。腹部粘连在因小肠绞窄导致严重结肠绞痛的马匹中最为常见。腹疝形成发生在8%的马匹中,在有术后伤口引流或感染的马匹中最为常见。

结论

本研究确定了各种似乎使马匹在结肠绞痛手术后易发生长期并发症的因素。

潜在意义

需要进一步评估可能降低此类并发症发生率的策略;特别是,应评估腹腔内肝素的价值,并评估旨在降低伤口引流和感染率的操作。

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