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钬激光碎石术治疗犬尿石症

Holmium: YAG laser lithotripsy for urolithiasis in dogs.

作者信息

Grant D C, Werre S R, Gevedon M L

机构信息

Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Medicine, Virginia Tech, Blacksburg, VA 24061-0442, USA.

出版信息

J Vet Intern Med. 2008 May-Jun;22(3):534-9. doi: 10.1111/j.1939-1676.2008.0083.x. Epub 2008 May 2.

Abstract

BACKGROUND

Laser lithotripsy has been used as an alternative to surgical removal of uroliths in a number of species.

OBJECTIVES

To determine the effectiveness of laser lithotripsy for removing urocystoliths, urethroliths, or both in dogs, and to determine the influence of dog (chronological order of lithotripsy, endoscope type, sex, body weight) and urolith (total urolith and urocystolith number, presence or absence of urethroliths, largest urolith dimension, and urolith composition) factors on outcome.

ANIMALS

Twenty-five client-owned dogs with urocystoliths, urethroliths, or both were included. Male dogs were required to weigh > or =6.8 kg.

METHODS

A single-arm prospective clinical trial. Laser lithotripsy was performed under general anesthesia. Main outcomes included procedure success and lithotripsy time. Predictors of procedure success and lithotripsy time were selected using logistic and linear regression modeling, respectively.

RESULTS

The procedure was successful in 21 of 25 dogs. The procedure was successful more often and in less time in female spayed than in male neutered dogs. Sex was identified as a predictor of success. Univariable analysis showed that sex, endoscope type, and chronological order in which the dog received lithotripsy were significantly associated with lithotripsy time. Stepwise linear regression modeling identified sex, body weight, >10 uroliths, and largest urolith dimension as predictors of lithotripsy time.

CONCLUSIONS AND CLINICAL IMPORTANCE

Laser lithotripsy is an effective procedure for the removal of urocystoliths, urethroliths, or both with rare important adverse effects and some limitations in male dogs.

摘要

背景

激光碎石术已被用作多种动物手术切除尿路结石的替代方法。

目的

确定激光碎石术去除犬膀胱结石、尿道结石或两者的有效性,并确定犬的因素(碎石术的时间顺序、内窥镜类型、性别、体重)和尿路结石因素(尿路结石总数和膀胱结石数、是否存在尿道结石、最大结石尺寸和结石成分)对治疗结果的影响。

动物

纳入25只患有膀胱结石、尿道结石或两者皆有的客户拥有的犬。雄性犬体重需≥6.8 kg。

方法

单臂前瞻性临床试验。在全身麻醉下进行激光碎石术。主要结局包括手术成功和碎石时间。分别使用逻辑回归和线性回归模型选择手术成功和碎石时间的预测因素。

结果

25只犬中有21只手术成功。绝育雌性犬手术成功率更高且所需时间比去势雄性犬少。性别被确定为成功的预测因素。单变量分析表明,性别、内窥镜类型和犬接受碎石术的时间顺序与碎石时间显著相关。逐步线性回归模型确定性别、体重、结石数量>10枚和最大结石尺寸为碎石时间的预测因素。

结论及临床意义

激光碎石术是一种有效去除膀胱结石、尿道结石或两者的方法,不良反应罕见且重要,但对雄性犬有一些局限性。

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