Gandini Marco
Facoltà di Medicina Veterinaria di Torino, Dipartimento di Patologia Animale, Università di Torino, 10095 Grugliasco, Torino, Italy.
J Am Vet Med Assoc. 2007 Jul 15;231(2):254-8. doi: 10.2460/javma.231.2.254.
To compare 3 dorsal techniques for arthrocentesis of the distal interphalangeal joint in horses with regard to ease of performing the technique and to determine the role of operator experience in ease of performing these techniques.
Observational study. Sample Population-Forelimbs from 17 equine cadavers and 12 horses (16 joints) undergoing arthrocentesis for therapeutic or diagnostic purposes.
In both forelimbs from 7 of the equine cadavers, 3 arthrocentesis techniques (dorsal perpendicular, dorsolateral, and dorsal inclined) were performed in random order by a single experienced individual, and number of attempts needed to successfully insert the needle into the joint was recorded. For the forelimbs from the remaining 10 cadavers, veterinary students without experience in arthrocentesis performed each of the 3 arthrocentesis techniques (2 limbs/student) in random order, and number of attempts was recorded. In the clinical patients, arthrocentesis was performed by means of the dorsal inclined technique.
For both the experienced individual and the veterinary students, number of attempts needed was significantly lower with the dorsal inclined technique than with the dorsal perpendicular or dorsolateral technique. Arthrocentesis was successful with the dorsal inclined technique in all 16 joints in the clinical patients; synovial fluid was recovered from 14 of the 16 joints. The procedure was well tolerated in all horses, except one that reacted to needle insertion.
Results suggested that the dorsal inclined technique for arthrocentesis of the distal interphalangeal joint was easier to perform than was the dorsal perpendicular or dorsolateral technique, regardless of experience level of the operator.
比较马远侧指间关节关节穿刺的3种背侧技术在操作难易程度方面的差异,并确定操作者经验对这些技术操作难易程度的影响。
观察性研究。样本群体——来自17具马尸体的前肢以及12匹马(16个关节),这些马因治疗或诊断目的而接受关节穿刺。
在7具马尸体的双侧前肢中,由一名经验丰富的个体按随机顺序进行3种关节穿刺技术(背侧垂直、背外侧和背侧倾斜)操作,并记录将针成功插入关节所需的尝试次数。对于其余10具尸体的前肢,由没有关节穿刺经验的兽医学生按随机顺序进行3种关节穿刺技术中的每一种操作(2个肢体/学生),并记录尝试次数。在临床病马中,采用背侧倾斜技术进行关节穿刺。
对于经验丰富的个体和兽医学生而言,背侧倾斜技术所需的尝试次数均显著低于背侧垂直或背外侧技术。临床病马的所有16个关节采用背侧倾斜技术进行关节穿刺均获成功;16个关节中有14个关节获取到了滑液。除1匹马对针刺有反应外,所有马匹对该操作耐受性良好。
结果表明,无论操作者的经验水平如何,远侧指间关节关节穿刺的背侧倾斜技术比背侧垂直或背外侧技术更容易操作。