Tatz A J, Segev G, Steinman A, Berlin D, Milgram J, Kelmer G
Large Animal Medicine and Surgery, Veterinary Medicine Teaching Hospital, Koret School of Veterinary Medicine, Smith Faculty of Agriculture, Hebrew University of Jerusalem, Israel.
Equine Vet J Suppl. 2012 Dec(43):111-4. doi: 10.1111/j.2042-3306.2012.00607.x.
There is a consensus in the veterinary literature that Parascaris equorum (ascarid) impaction carries a poor prognosis. Hence surgery is often delayed and foals are often subjected to euthanasia after diagnosis of ascarid impaction is established. Our clinical impression was that ascarid impaction carries a better prognosis than previously reported.
Our expectation was that manually evacuating the impaction into the caecum, thus refraining from opening the small intestine, would improve the prognosis for survival of horses with ascarid impaction. The aim of this study was to examine medical records of horses treated surgically for ascarid impaction, record their clinical findings and evaluate the association of outcome with the method of relieving the impaction.
The medical records of all horses presented to our hospital between October 2002 and December 2011 that underwent exploratory celiotomy for ascarid impaction were reviewed. Information retrieved from the medical record included surgical findings, surgical technique, complications, short- and long-term survival. The association between categorical variables was assessed using the Fisher's exact test. A P value < 0.05 was considered statistically significant.
Fifteen horses fulfilled the inclusion criteria. Eighty percent of horses (12/15) survived to discharge and 60% (6/10) survived for at least one year. Five horses are doing well but are still in convalescence. Horses that underwent small intestinal enterotomy or resection and anastomosis (n = 5) were less likely to survive to discharge (P = 0.022).
In our study, manual evacuation of ascarid impaction into the caecum, while refraining from opening the small intestine resulted in significantly improved survival in horses with ascarid impaction.
Refraining from opening the small intestine may be the key to improving surgical outcome in horses with ascarid impaction.
兽医文献中存在一种共识，即马副蛔虫（蛔虫）阻塞的预后较差。因此，手术往往会延迟，并且在确诊蛔虫阻塞后，幼驹常常会被实施安乐死。我们的临床印象是，蛔虫阻塞的预后比先前报道的要好。
我们期望通过手动将阻塞物排入盲肠，从而避免打开小肠，以此改善患有蛔虫阻塞的马匹的生存预后。本研究的目的是检查因蛔虫阻塞接受手术治疗的马匹的病历，记录其临床发现，并评估治疗结果与解除阻塞方法之间的关联。
回顾了2002年10月至2011年12月期间到我院接受剖腹探查术以治疗蛔虫阻塞的所有马匹的病历。从病历中获取的信息包括手术发现、手术技术、并发症、短期和长期生存情况。使用Fisher精确检验评估分类变量之间的关联。P值<0.05被认为具有统计学意义。
15匹马符合纳入标准。80%的马匹（12/15）存活至出院，60%（6/10）存活至少一年。5匹马情况良好，但仍处于恢复期。接受小肠切开术或切除吻合术的马匹（n = 5）存活至出院的可能性较小（P = 0.022）。
在我们的研究中，将蛔虫阻塞物手动排入盲肠，同时避免打开小肠，可显著提高患有蛔虫阻塞的马匹的生存率。
避免打开小肠可能是改善患有蛔虫阻塞的马匹手术结果的关键。
