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小反刍动物梗阻性尿路结石手术置管膀胱造瘘术后的短期和长期预后及生存预测因素。

Short- and long-term outcome and factors predicting survival after surgical tube cystostomy for treatment of obstructive urolithiasis in small ruminants.

作者信息

Ewoldt Jennifer M, Anderson David E, Miesner Matt D, Saville William J

机构信息

Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA.

出版信息

Vet Surg. 2006 Jul;35(5):417-22. doi: 10.1111/j.1532-950X.2006.00169.x.

Abstract

OBJECTIVE

To evaluate outcome of small ruminants after tube cystostomy without urethral flushing.

STUDY DESIGN

Retrospective clinical study.

ANIMALS

Small ruminants (n=63; 50 goats, 13 sheep).

METHODS

Medical records (January 1996-October 2003) for all small ruminants undergoing tube cystostomy were analyzed. Signalment, laboratory data, intraoperative findings, urolith type, and postoperative outcome were compared. Long-term follow-up was obtained at 6 and > or= 12 months postoperatively.

RESULTS

Most animals were castrated males. Pygmy goats were overrepresented. Mean time to normal urination after tube cystostomy was 11 days, and mean hospitalization was 14 days. Seventy-six percent of animals were successfully treated with tube cystostomy (90% of those discharged from hospital). Short- and long-term survival was good for those animals with follow-up data. Reobstruction occurred in <20% of animals at 6 and 12 months. Goats, castrated males, and animals with normal serum potassium, no fluid in the abdomen, or no urethral process amputation were more likely to survive. Stone type, bladder appearance, and age at castration were not associated with outcome.

CONCLUSION

Surgical tube cystostomy without urethral flushing is an effective technique for resolution of obstructive urolithiasis in small ruminants.

CLINICAL RELEVANCE

Goats, small ruminants with an intact urethral process, absence of abdominal fluid, and serum potassium concentration <5.2 mEq/L at admission were all associated with survival after tube cystostomy. Castrated males may also be more likely to survive. These factors should be considered in management of small ruminants with urolithiasis.

摘要

目的

评估小型反刍动物在未进行尿道冲洗的情况下行膀胱造瘘管置入术后的结局。

研究设计

回顾性临床研究。

动物

小型反刍动物(n = 63;50只山羊,13只绵羊)。

方法

分析1996年1月至2003年10月期间所有接受膀胱造瘘管置入术的小型反刍动物的病历。比较动物的特征、实验室数据、术中发现、尿路结石类型及术后结局。术后6个月及≥12个月进行长期随访。

结果

大多数动物为去势雄性。侏儒山羊占比过高。膀胱造瘘管置入术后恢复正常排尿的平均时间为11天,平均住院时间为14天。76%的动物通过膀胱造瘘管置入术得到成功治疗(出院动物中90%)。有随访数据的动物短期和长期存活率良好。6个月和12个月时,<20%的动物出现再次梗阻。山羊、去势雄性以及血清钾正常、腹部无积液或未行尿道突切除术的动物更有可能存活。结石类型、膀胱外观及去势时的年龄与结局无关。

结论

不进行尿道冲洗的手术膀胱造瘘管置入术是解决小型反刍动物梗阻性尿路结石的有效技术。

临床意义

山羊、尿道突完整的小型反刍动物、入院时无腹腔积液且血清钾浓度<5.2 mEq/L的动物,在膀胱造瘘管置入术后均与存活相关。去势雄性动物也可能更易存活。在治疗患有尿路结石的小型反刍动物时应考虑这些因素。

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