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幽门和非幽门胃肠道穿孔所致的化脓性腹膜炎:44只犬和11只猫的预后因素

Septic peritonitis from pyloric and non-pyloric gastrointestinal perforation: prognostic factors in 44 dogs and 11 cats.

作者信息

Dayer T, Howard J, Spreng D

机构信息

Department of Small Animal Surgery, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

出版信息

J Small Anim Pract. 2013 Dec;54(12):625-9. doi: 10.1111/jsap.12151. Epub 2013 Oct 24.

Abstract

OBJECTIVES

To identify potential prognostic factors affecting outcome in septic peritonitis caused by gastrointestinal perforation in dogs and cats.

METHODS

A retrospective study. Animals operated on for septic peritonitis because of gastrointestinal perforation were evaluated. Risk factors assessed included age, duration of clinical signs, recent prior abdominal surgery, recent prior anti-inflammatory drug administration, placement of a closed-suction drain and location of perforation.

RESULTS

Fifty-five animals (44 dogs and 11 cats) were included. The overall mortality was 63·6%. No association was found between age, duration of clinical signs or prior abdominal surgery and outcome. Animals with a history of prior anti-inflammatory drugs were significantly (P=0·0011) more likely to have perforation of the pylorus (73·3%). No significant difference in outcome was found between animals treated with closed-suction drains and those treated with primary closure or between pyloric perforation and perforation at other gastrointestinal sites.

CLINICAL SIGNIFICANCE

Administration of anti-inflammatory drugs in dogs and cats is a significant risk factor for pyloric perforation. Pyloric perforation was not associated with a poorer outcome than perforation at other gastrointestinal sites. Placement of a closed suction drain did not improve outcome compared to primary closure.

摘要

目的

确定影响犬猫胃肠穿孔所致化脓性腹膜炎预后的潜在因素。

方法

一项回顾性研究。对因胃肠穿孔接受化脓性腹膜炎手术的动物进行评估。评估的风险因素包括年龄、临床症状持续时间、近期腹部手术史、近期抗炎药物使用情况、闭式引流管放置情况及穿孔位置。

结果

纳入55只动物(44只犬和11只猫)。总体死亡率为63.6%。未发现年龄、临床症状持续时间或既往腹部手术与预后之间存在关联。有抗炎药物使用史的动物幽门穿孔的可能性显著更高(P = 0.0011)(73.3%)。在接受闭式引流治疗的动物与接受一期缝合治疗的动物之间,以及幽门穿孔与其他胃肠部位穿孔之间,未发现预后有显著差异。

临床意义

犬猫使用抗炎药物是幽门穿孔的一个重要风险因素。与其他胃肠部位穿孔相比,幽门穿孔的预后并不更差。与一期缝合相比,放置闭式引流管并未改善预后。

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