Gardner I A, Reynolds J P, Risco C A, Hird D W
Department of Epidemiology and Preventive Medicine, School of Veterinary Medicine, University of California, Davis 95616.
J Am Vet Med Assoc. 1990 Oct 15;197(8):1021-4.
A 12-month study was undertaken in a 9-veterinarian dairy practice to determine patterns of uterine prolapse and factors associated with posttreatment survival. Of 220,000 cows in herds visited by veterinarians from the practice, 200 (0.09%) developed prolapses mostly (155/169 with data) in the first 24 hours after calving. Most cows (130/200) had prolapses during fall and winter months, and assistance was required in 47 of 200 calvings that resulted in prolapses. Treatment of affected cows (n = 196) consisted of cleansing and replacement of the uterus, insertion of perivulvar retention sutures, local and systemic administration of antibiotics, and parenteral administration of dexamethasone and oxytocin. Calcium was administered to cows with milk fever (n = 117) and to multiparous cows without milk fever attended by veterinarian 9 (n = 8). Crude recovery rate after 2 weeks was 72.4%, but recovery was significantly better if the calf was born alive (P = 0.001), the cow was primiparous (P = 0.03), the cow did not have stage-3 milk fever (P = 0.003), or if the cow was attended by veterinarian 9 (P = 0.01). Time to treatment was not significantly associated with recovery, but affected cows were treated mostly (127/156) within 2 hours of occurrence of the prolapse. By multivariable analysis, presence of a liveborn calf, parity, and lack of stage-3 milk fever, but not attending veterinarian, were significant (P less than 0.05) prognostic indicators of 2-week survival.
在一家拥有9名兽医的奶牛场进行了一项为期12个月的研究，以确定子宫脱垂模式以及与治疗后存活相关的因素。在该诊所兽医出诊的牛群中，220,000头奶牛中有200头（0.09%）发生了脱垂，其中大部分（155/169，有数据记录）发生在产犊后的头24小时内。大多数奶牛（130/200）在秋冬季节发生脱垂，在导致脱垂的200次产犊中有47次需要助产。对患病奶牛（n = 196）的治疗包括子宫清洗和复位、外阴周围留置缝线、局部和全身使用抗生素，以及静脉注射地塞米松和催产素。对患乳热的奶牛（n = 117）以及兽医9护理的无乳热经产奶牛（n = 8）补充了钙。2周后的粗恢复率为72.4%，但如果犊牛存活（P = 0.001）、奶牛为初产（P = 0.03）、奶牛没有3期乳热（P = 0.003）或奶牛由兽医9护理（P = 0.01），恢复情况会明显更好。治疗时间与恢复情况无显著关联，但大多数患病奶牛（127/156）在脱垂发生后2小时内接受了治疗。通过多变量分析，活产犊牛的存在、胎次以及无3期乳热，但不包括护理兽医，是2周存活的显著（P < 0.05）预后指标。
