Underwood C, Southwood L L, McKeown L P, Knight D
University of Pennsylvania, Department of Clinical Studies, 382 W. Street Road, Kennett Square, PA 19348, USA.
Equine Vet J. 2008 Jun;40(4):373-8. doi: 10.2746/042516408X302492.
Based on clinical observation, it is hypothesised that horses with duodenitis-proximal jejunitis (DPJ) that are treated surgically have a shorter duration, smaller volume, and slower rate of nasogastric reflux (NGR) compared to horses treated medically, are more likely to develop diarrhoea than medically managed cases, and have a higher incisional infection rate than a sample population of horses undergoing abdominal exploration for gastrointestinal disease other than DPJ.
To compare: 1) duration, volume and rate of NGR and the percentage of horses with diarrhoea between medically and surgically treated DPJ cases; and 2) incisional infection rate in horses with DPJ undergoing abdominal exploration to a sample population of horses undergoing abdominal exploration for gastrointestinal disease other than DPJ.
Medical records of cases with DPJ diagnosed 1995-2006 were reviewed. Information obtained included subject details, presenting clinical findings, treatment category (medical/surgical), complications (diarrhoea, incisional infection), and outcome (survival/nonsurvival). Data were analysed using a Chi-squared test and a mixed model analysis of variance. Level of significance was P<0.05.
Compared to medical cases, surgical cases had significantly decreased survival, a longer duration and larger total volume of NGR, and were more likely to develop diarrhoea. The incisional infection rate for horses with DPJ undergoing abdominal exploration was 16% compared to 7% for the sample population of horses.
Surgical treatment of horses with DPJ did not lead to resolution of NGR faster than medical treatment. Surgical cases were more likely to develop diarrhoea and did not have a significantly higher incisional infection rate than the sample population.
基于临床观察，提出如下假设：与接受内科治疗的马相比，接受手术治疗的患十二指肠炎-近端空肠炎（DPJ）的马，其鼻胃反流（NGR）的持续时间更短、量更小、速率更慢，比内科治疗的病例更易发生腹泻，并且与因非DPJ的胃肠疾病而接受腹部探查的马样本群体相比，其切口感染率更高。
比较：1）内科和手术治疗的DPJ病例之间NGR的持续时间、量和速率以及腹泻马的百分比；2）接受腹部探查的DPJ患马与因非DPJ的胃肠疾病而接受腹部探查的马样本群体的切口感染率。
回顾1995年至2006年诊断为DPJ的病例的病历。获取的信息包括受试者详细信息、临床表现、治疗类别（内科/外科）、并发症（腹泻、切口感染）和结局（存活/未存活）。使用卡方检验和方差混合模型分析对数据进行分析。显著性水平为P<0.05。
与内科治疗的病例相比，手术治疗的病例存活率显著降低，NGR持续时间更长、总量更大，并且更易发生腹泻。接受腹部探查的DPJ患马的切口感染率为16%，而马样本群体的切口感染率为7%。
对患DPJ的马进行手术治疗并不会比内科治疗更快地消除NGR。手术治疗的病例更易发生腹泻，且切口感染率与样本群体相比并无显著升高。
