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对44匹患有累及肢体远端滑膜损伤的马,使用头静脉或隐静脉留置导管进行肢体局部灌注。

Indwelling cephalic or saphenous vein catheter use for regional limb perfusion in 44 horses with synovial injury involving the distal aspect of the limb.

作者信息

Kelmer Gal, Tatz Amos, Bdolah-Abram Tali

机构信息

Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Israel.

出版信息

Vet Surg. 2012 Nov;41(8):938-43. doi: 10.1111/j.1532-950X.2012.01006.x. Epub 2012 Jul 18.

Abstract

OBJECTIVE

To describe indwelling cephalic or saphenous vein catheter use for intravenous regional limb perfusion (ID-IV-RLP) to treat horses with synovial injury (contamination/infection) of the distal aspect of the limb.

STUDY DESIGN

Retrospective case series.

ANIMALS

Horses (n = 44; 45 limbs) treated with proximal ID-IV-RLP.

METHODS

Horses had ID-IV-RLP using a cephalic (21 limbs) or saphenous (24 limbs) vein. Amikacin was the most frequently used antibiotic. Number of perfusions ranged from 3 to 21 (median 7). A cast was applied to 14 injured limbs (1 tube cast, 1 full-limb cast, 2 foot casts, and 10 half-limb casts).

RESULTS

Synovial sepsis of the distal portion of 87% of limbs (39) resolved, and 61% of horses returned to soundness. Catheter-related complications occurred in 27% of the limbs but were not significantly associated with outcome. Presence of osteomyelitis was significantly associated with a poor outcome.

CONCLUSIONS

ID-IV-RLP using the cephalic or saphenous vein is an alternative to traditional RLP. An indwelling catheter provided prolonged venous access and facilitated successive perfusions.

摘要

目的

描述使用头静脉或隐静脉留置导管进行肢体区域静脉灌注(ID-IV-RLP)治疗肢体远端滑膜损伤(污染/感染)的马匹。

研究设计

回顾性病例系列。

动物

接受近端ID-IV-RLP治疗的马匹(n = 44;45条肢体)。

方法

马匹采用头静脉(21条肢体)或隐静脉(24条肢体)进行ID-IV-RLP。阿米卡星是最常用的抗生素。灌注次数为3至21次(中位数为7次)。14条受伤肢体使用了石膏(1个管型石膏、1个全肢体石膏、2个足部石膏和10个半肢体石膏)。

结果

87%的肢体(39条)远端滑膜脓毒症得到解决,61%的马匹恢复健康。27%的肢体出现了与导管相关的并发症,但与治疗结果无显著关联。骨髓炎的存在与不良预后显著相关。

结论

使用头静脉或隐静脉进行ID-IV-RLP是传统RLP的一种替代方法。留置导管提供了长时间的静脉通路,并便于进行连续灌注。

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