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正常犬剖腹术后腹腔引流液量、细胞学检查及血腹乳酸和葡萄糖差异评估

Evaluation of postceliotomy peritoneal drain fluid volume, cytology, and blood-to-peritoneal fluid lactate and glucose differences in normal dogs.

作者信息

Szabo Stephanie D, Jermyn Kieri, Neel Jennifer, Mathews Kyle G

机构信息

Department of Clinical Sciences, North Carolina State University School of Veterinary Medicine, Raleigh, NC 27606, USA.

出版信息

Vet Surg. 2011 Jun;40(4):444-9. doi: 10.1111/j.1532-950X.2011.00799.x. Epub 2011 Apr 5.

Abstract

OBJECTIVE

To describe peritoneal drain fluid volume, fluid cytology, and blood-to-peritoneal fluid lactate and glucose concentration differences after exploratory celiotomy in normal dogs.

STUDY DESIGN

Prospective study.

ANIMALS

Healthy Beagle dogs (n=10).

METHODS

After exploratory celiotomy, a peritoneal drain was placed, and peritoneal fluid was recorded every 6 hours for 7 days. Fluid was submitted for cytologic examination, and fluid and blood glucose and lactate concentrations were recorded every 12 hours. On day 7, drains were removed and drain tips submitted for aerobic bacterial culture.

RESULTS

Mean peritoneal fluid volume decreased from 2.8 mL/kg/day (day 1) to 0.6 mL/kg/day (day 7). All dogs had degenerate neutrophils in peritoneal fluid throughout the 7 days. Four dogs developed contaminated drains. Blood-to-peritoneal glucose concentration differences > 20 mg/dL occurred after day 4. By day 7, 5 of 7 dogs with patent drains had blood-to-peritoneal lactate concentration differences < -2 mmol/L.

CONCLUSION

After day 4, blood-to-peritoneal glucose concentration differences were consistent with septic effusion based on previously reported values used to diagnose septic peritonitis in dogs. Blood-to-peritoneal lactate concentration differences varied but after day 4, >70% of dogs had differences consistent with septic peritonitis each day. Postoperative blood-to-peritoneal fluid glucose and lactate difference may not be reliable indicators of septic peritonitis when evaluating abdominal fluid collected with closed suction drains.

摘要

目的

描述正常犬剖腹探查术后腹腔引流液量、液体细胞学检查结果,以及血液与腹腔液中乳酸和葡萄糖浓度的差异。

研究设计

前瞻性研究。

动物

健康比格犬(n = 10)。

方法

剖腹探查术后放置腹腔引流管,连续7天每6小时记录一次腹腔液量。采集液体进行细胞学检查,每12小时记录一次液体及血液中的葡萄糖和乳酸浓度。在第7天,拔除引流管,将引流管尖端送去进行需氧菌培养。

结果

腹腔液平均量从第1天的2.8 mL/kg/天降至第7天的0.6 mL/kg/天。在整个7天内,所有犬的腹腔液中均有变性中性粒细胞。4只犬出现引流管污染。第4天后血液与腹腔液葡萄糖浓度差值>20 mg/dL。到第7天,7只引流管通畅的犬中有5只血液与腹腔液乳酸浓度差值<-2 mmol/L。

结论

根据先前报道的用于诊断犬脓毒性腹膜炎的数值,第4天后血液与腹腔液葡萄糖浓度差值符合脓毒性积液。血液与腹腔液乳酸浓度差值有所变化,但第4天后,每天>70%的犬的差值符合脓毒性腹膜炎。在评估通过闭式吸引引流管收集的腹腔液时,术后血液与腹腔液葡萄糖和乳酸差值可能不是脓毒性腹膜炎的可靠指标。

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