Lindegaard C, Ekstrøm C T, Wulf S B, Vendelbo J M B, Andersen P H
Department of Large Animal Sciences, University of Copenhagen, Denmark.
Equine Vet J Suppl. 2011 Aug(39):63-8. doi: 10.1111/j.2042-3306.2011.00376.x.
Previous studies indicate similar overall survival of horses with nephrosplenic entrapment of the large colon (NSE), regardless of treatment strategy. Short-term survival of a primarily conservative treatment strategy without rolling under general anaesthesia (GA) and a low proportion of surgical intervention as well as indicators of short-term nonsurvival has not been documented.
To document short-term survival of horses with NSE treated in a university referral hospital with a low rate of surgical interventions and to determine factors associated with the decision of treatment and short-term nonsurvival.
A retrospective review of medical records of 142 horses diagnosed with NSE between January 2000 and October 2009 was undertaken. Case details and clinical parameters from the initial examination, treatment and outcome were recorded. Factors associated with decision of treatment and short-term survival were identified by multiple logistic regression analysis.
Warmblood breeds were over-represented in comparison to the general colic population. Overall short-term survival was 91.5% (130/142) which is similar to previous studies. Three horses considered to be in need of surgery were subjected to euthanasia for economical reasons before treatment. Of 114 conservatively treated horses, 110 (96.5%) survived, as did 20/25 (80%) of surgically treated horses. Nine conservatively managed horses were treated with phenylephrine. Gastric reflux (P = 0.0077), pain (P = 0.024) and abdominal distension (P = 0.05) were associated with the decision to treat surgically. Increased heart rate (P<0.001), and surgery (P = 0.032) were associated with reduced likelihood of short-term survival.
Overall short-term survival was similar to that reported in previous studies with higher proportions of surgically managed cases. Consequently, horses with NSE should be managed by a primarily conservative treatment strategy, with the decision to treat surgically based on specific evidence based criteria.
既往研究表明，无论采用何种治疗策略，患有大结肠肾脾陷闭（NSE）的马匹总体生存率相似。尚未有关于在不进行全身麻醉（GA）下翻滚的主要保守治疗策略的短期生存率、手术干预比例低以及短期非生存指标的记录。
记录在一所大学转诊医院接受治疗且手术干预率低的患有NSE的马匹的短期生存率，并确定与治疗决策和短期非生存相关的因素。
对2000年1月至2009年10月期间诊断为NSE的142匹马的病历进行回顾性研究。记录了初始检查、治疗和结果的病例详细信息及临床参数。通过多因素逻辑回归分析确定与治疗决策和短期生存相关的因素。
与一般腹痛病例群体相比，温血品种的马匹占比过高。总体短期生存率为91.5%（130/142），与既往研究相似。3匹被认为需要手术的马匹因经济原因在治疗前实施了安乐死。在114匹接受保守治疗的马匹中，110匹（96.5%）存活，接受手术治疗的25匹中的20匹（80%）也存活。9匹接受保守治疗的马匹使用了去氧肾上腺素。胃反流（P = 0.0077）、疼痛（P = 0.024）和腹胀（P = 0.05）与手术治疗决策相关。心率加快（P<0.001）和手术（P = 0.032）与短期生存可能性降低相关。
总体短期生存率与既往报道的手术治疗病例比例较高的研究相似。因此，患有NSE的马匹应以主要保守治疗策略进行管理，手术治疗决策应基于特定的循证标准。
