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羧甲基纤维素钠给药分析及与小肠疾病马匹术后绞痛和生存相关的因素

Analysis of sodium carboxymethylcellulose administration and related factors associated with postoperative colic and survival in horses with small intestinal disease.

作者信息

Fogle Callie A, Gerard Mathew P, Elce Yvonne A, Little Dianne, Morton Alison J, Correa Maria T, Blikslager Anthony T

机构信息

Department of Clinical Sciences and Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27606, USA.

出版信息

Vet Surg. 2008 Aug;37(6):558-63. doi: 10.1111/j.1532-950X.2008.00420.x.

Abstract

OBJECTIVE

To analyze the effect of the intraoperative use of sodium carboxymethylcellulose (CBMC) and related perioperative factors on postoperative colic and survival in horses that had abdominal surgery for colic.

STUDY DESIGN

Retrospective study.

ANIMALS

Horses (n=203) that had surgery for small intestinal disease; 33 horses had intraoperative administration of CBMC.

METHODS

Information was obtained from medical records for 170 horses that had surgery for colic before use of CBMC and 33 horses that had intraoperative CBMC. Kaplan-Meier survival curves were used to estimate median survival time and a Cox proportional hazards model was used to estimate the hazard ratio for the effect of CBMC and other perioperative variables on survival.

RESULTS

Seventy-five percent of horses administered CBMC survived to 180 days, whereas 75% of untreated horses survived 8 days (median survival time=18 days). Horses not administered CBMC were twice as likely to die compared with horses administered CBMC. Horses that had postoperative ileus (POI) were 1.4 times more likely to die than horses without ileus. Similarly, horses with signs of colic after surgery were 1.3 times more likely to die than horses without postoperative signs of colic.

CONCLUSIONS

CBMC administration is seemingly protective against death and prolongs survival when used intraoperatively in horses with small intestine disease, particularly horses with postoperative colic or POI. Both POI and colic increased risk of death after surgery.

CLINICAL RELEVANCE

Intraoperative administration of CBMC in horses that have surgery for small intestinal disease may improve survival, possibly by reducing early adhesion formation.

摘要

目的

分析术中使用羧甲基纤维素钠(CBMC)及相关围手术期因素对因腹痛接受腹部手术的马匹术后绞痛和生存情况的影响。

研究设计

回顾性研究。

动物

因小肠疾病接受手术的马匹(n = 203);33匹马术中给予CBMC。

方法

从170匹在使用CBMC之前因腹痛接受手术的马匹和33匹术中使用CBMC的马匹的病历中获取信息。采用Kaplan-Meier生存曲线估计中位生存时间,采用Cox比例风险模型估计CBMC及其他围手术期变量对生存影响的风险比。

结果

接受CBMC治疗的马匹中有75%存活至180天,而未治疗的马匹中有75%存活8天(中位生存时间 = 18天)。未接受CBMC治疗的马匹死亡可能性是接受CBMC治疗马匹的两倍。发生术后肠梗阻(POI)的马匹死亡可能性比未发生肠梗阻的马匹高1.4倍。同样,术后有腹痛迹象的马匹死亡可能性比无术后腹痛迹象的马匹高1.3倍。

结论

在患有小肠疾病的马匹术中使用CBMC似乎可预防死亡并延长生存期,尤其是对有术后绞痛或POI的马匹。POI和绞痛均增加了术后死亡风险。

临床意义

对因小肠疾病接受手术的马匹术中给予CBMC可能通过减少早期粘连形成来提高生存率。

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