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猫的头部创伤:1. 颅面部损伤的评估与处理

Head trauma in the cat: 1. assessment and management of craniofacial injury.

作者信息

Adamantos Sophie, Garosi Laurent

机构信息

Department of Veterinary Clinical Sciences, Royal Veterinary College, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.

出版信息

J Feline Med Surg. 2011 Nov;13(11):806-14. doi: 10.1016/j.jfms.2011.09.002.

DOI:10.1016/j.jfms.2011.09.002
PMID:22063205
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10911293/
Abstract

PRACTICAL RELEVANCE

Feline trauma is commonly seen in general practice and frequently involves damage to the head.

CLINICAL CHALLENGES

While craniofacial injuries following trauma vary widely in severity, affected cats can often be severely compromised in terms of their neurological, respiratory and cardiovascular status, and their management can be challenging in both the short and long term. They need prompt stabilisation and careful monitoring in the initial period to maximise prospects of a successful outcome. Many cats with severe facial trauma will require surgery to stabilise skull fractures or address injuries to the eyes, with its inherent issues surrounding pain management, ensuring adequate nutrition and the necessity for ongoing hospitalisation.

DIAGNOSTICS

Cats with head trauma benefit from imaging of the injured areas as well as thoracic radiography. Imaging the skull can be challenging and is best performed under general anaesthesia. In unstable patients this can be delayed to prevent any associated morbidity.

EVIDENCE BASE

The clinical evidence base relating to injury to the feline head is limited, despite its relative frequency in general practice. This review focuses on the initial approach to craniofacial (in particular, ocular and jaw) trauma, and outlines simple techniques for management of soft tissue and bone injuries. Much of the information is based on the authors' clinical experience, as there is a paucity of well-described clinical case material.

摘要

实际意义

猫科动物创伤在普通临床实践中很常见,且经常涉及头部损伤。

临床挑战

虽然创伤后的颅面损伤严重程度差异很大,但受影响的猫在神经、呼吸和心血管状况方面往往会受到严重影响,其短期和长期管理都具有挑战性。在初始阶段,它们需要迅速稳定病情并进行仔细监测,以最大程度提高成功治疗的几率。许多严重面部创伤的猫需要进行手术以稳定颅骨骨折或处理眼部损伤,这涉及疼痛管理、确保充足营养以及持续住院治疗等固有问题。

诊断

头部创伤的猫受益于受伤部位的影像学检查以及胸部X光检查。对颅骨进行成像可能具有挑战性,最好在全身麻醉下进行。对于不稳定的患者,这可以推迟以防止任何相关的发病率。

证据基础

尽管猫头部损伤在普通临床实践中相对常见,但与之相关的临床证据基础有限。本综述重点关注颅面(特别是眼部和颌部)创伤的初始处理方法,并概述软组织和骨损伤的简单管理技术。由于缺乏详细描述的临床病例材料,大部分信息基于作者的临床经验。

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JAMA. 2010 Oct 6;304(13):1455-64. doi: 10.1001/jama.2010.1405.
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Clinical experience using 5% hypertonic saline as a safe alternative fluid for use in trauma.将5%高渗盐水用作创伤治疗中安全替代液体的临床经验。
J Trauma. 2010 May;68(5):1172-7. doi: 10.1097/TA.0b013e3181d76d40.
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Fluid resuscitation: past, present, and the future.液体复苏:过去、现在和未来。
Shock. 2010 Mar;33(3):229-41. doi: 10.1097/SHK.0b013e3181c30f0c.
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The diagnostic yield of conventional radiographs and computed tomography in dogs and cats with maxillofacial trauma.传统X线片和计算机断层扫描在患有颌面部创伤的犬猫中的诊断价值。
Vet Surg. 2008 Apr;37(3):294-9. doi: 10.1111/j.1532-950X.2008.00380.x.
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