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 4 部分：早期（急性）再次剖腹探查术。

Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: Early (acute) relaparotomy.

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):315-8. doi: 10.2746/0425164054529454.

DOI:10.2746/0425164054529454

PMID:16028619

Abstract

REASONS FOR PERFORMING STUDY

Early (acute) relaparotomy after surgery for equine colic is widely considered to be an acceptable treatment option for management of certain post operative complications. However, there is relatively little published information about resulting complication rates and short- and long-term outcomes.

OBJECTIVES

To document the proportions, indications, complication rates and survival rates of horses undergoing acute relaparatomy following colic surgery.

METHODS

History, clinical findings, surgical findings and procedures, post operative treatments and outcome 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

Acute relaparotomy was performed in 27/254 horses (10.6%) that recovered from initial general anaesthesia. The indications for relaparotomy included persistent pain, persistent ileus, peritonitis and wound breakdown. Of these 27 horses, 21 (77.8%) recovered from the second surgery, of which 8 (29.6%) died during the immediate post operative period. Thirteen of the 27 horses (48.2%) were discharged. Of these 13 horses, 5 (38.5%) were re-admitted to the hospital for surgical treatment of a subsequent bout of colic. The long-term survival rate for the 27 horses that underwent relaparotomy was 22.2%. Colic following discharge after relaparotomy was recorded in 69.2% of cases.

CONCLUSIONS

Relaparotomy is necessary in approximately 10% of horses undergoing surgery for acute colic. Persistent pain and post operative ileus were the most common indications. The short-term survival rate for horses requiring relaparotomy was approximately 50% and the long-term survival rate 22%. Nearly 40% of horses surviving relaparotomy developed episodes of acute colic that necessitated further surgery.

POTENTIAL RELEVANCE

Owners of horses requiring early (acute) relaparotomy should be advised of the high complication rates for this procedure.

摘要

开展本研究的原因

马属动物结肠绞痛手术后早期（急性）再次剖腹术被广泛认为是处理某些术后并发症的一种可接受的治疗选择。然而，关于由此产生的并发症发生率以及短期和长期预后的已发表信息相对较少。

目的

记录结肠绞痛手术后接受急性再次剖腹术的马匹的比例、指征、并发症发生率和存活率。

方法

回顾了300例连续的外科结肠绞痛病例（1994 - 2001年）的病史、临床检查结果、手术发现和操作、术后治疗及预后。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

254匹从初次全身麻醉中恢复的马中有27匹（10.6%）接受了急性再次剖腹术。再次剖腹术的指征包括持续性疼痛、持续性肠梗阻、腹膜炎和伤口裂开。这27匹马中，21匹（77.8%）从第二次手术中恢复，其中8匹（29.6%）在术后即刻死亡。27匹马中有13匹（48.2%）出院。在这13匹马中，5匹（38.5%）因随后的结肠绞痛发作再次入院接受手术治疗。接受再次剖腹术的27匹马的长期存活率为22.2%。再次剖腹术后出院的病例中，69.2%记录到结肠绞痛复发。