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地塞米松用于急性胸腰椎间盘突出症犬的不良反应及预后:161例(2000 - 2006年)

Adverse effects and outcome associated with dexamethasone administration in dogs with acute thoracolumbar intervertebral disk herniation: 161 cases (2000-2006).

作者信息

Levine Jonathan M, Levine Gwendolyn J, Boozer Lindsay, Schatzberg Scott J, Platt Simon R, Kent Marc, Kerwin Sharon C, Fosgate Geoffrey T

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA.

出版信息

J Am Vet Med Assoc. 2008 Feb 1;232(3):411-7. doi: 10.2460/javma.232.3.411.

Abstract

OBJECTIVE

To determine complications and neurologic outcomes associated with dexamethasone administration to dogs with surgically treated thoracolumbar intervertebral disk herniation, compared with dogs not receiving dexamethasone.

DESIGN

Retrospective case series.

ANIMALS

161 dogs with surgically confirmed thoracolumbar disk herniation.

PROCEDURES

Medical records from 2 hospitals were used to identify dogs that had received dexamethasone < 48 hours prior to admission (dexamethasone group dogs), dogs that received glucocorticoids other than dexamethasone < 48 hours prior to admission (other-glucocorticoid group dogs), and dogs that received no glucocorticoids (nontreatment group dogs). Signalment, neurologic injury grade, laboratory data, and complications were extracted from medical records.

RESULTS

Dexamethasone group dogs were 3.4 times as likely to have a complication, compared with other-glucocorticoid or nontreatment group dogs. Dexamethasone group dogs were 11.4 times as likely to have a urinary tract infection and 3.5 times as likely to have diarrhea, compared with other-glucocorticoid or nontreatment group dogs. No differences in neurologic function at discharge or recheck evaluation were detected among groups.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that treatment with dexamethasone before surgery is associated with more adverse effects, compared with treatment with glucocorticoids other than dexamethasone or no treatment with glucocorticoids, in dogs with thoracolumbar intervertebral disk herniation. In this study population, no difference in outcome was found among groups. These findings suggest that the value of dexamethasone administration before surgery in dogs with thoracolumbar disk herniation should be reconsidered.

摘要

目的

确定与接受手术治疗的胸腰椎椎间盘突出症犬只使用地塞米松相关的并发症和神经学转归,并与未接受地塞米松的犬只进行比较。

设计

回顾性病例系列研究。

动物

161只经手术确诊为胸腰椎椎间盘突出症的犬只。

方法

使用两家医院的病历,确定入院前<48小时接受地塞米松治疗的犬只(地塞米松组犬只)、入院前<48小时接受除地塞米松以外的糖皮质激素治疗的犬只(其他糖皮质激素组犬只)以及未接受糖皮质激素治疗的犬只(非治疗组犬只)。从病历中提取信号、神经损伤分级、实验室数据和并发症信息。

结果

与其他糖皮质激素组或非治疗组犬只相比,地塞米松组犬只出现并发症的可能性高3.4倍。与其他糖皮质激素组或非治疗组犬只相比,地塞米松组犬只发生尿路感染的可能性高11.4倍,发生腹泻的可能性高3.5倍。各组在出院时或复查评估时的神经功能无差异。

结论及临床意义

结果表明,对于胸腰椎椎间盘突出症犬只,与使用除地塞米松以外的糖皮质激素治疗或不使用糖皮质激素治疗相比,术前使用地塞米松治疗会带来更多不良反应。在本研究群体中,各组间转归无差异。这些发现提示,应重新考虑在胸腰椎椎间盘突出症犬只术前使用地塞米松的价值。

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