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疾病持续时间影响接受手术治疗的大结肠扭转纯血母马出院时的存活率。

Duration of disease influences survival to discharge of Thoroughbred mares with surgically treated large colon volvulus.

作者信息

Hackett E S, Embertson R M, Hopper S A, Woodie J B, Ruggles A J

机构信息

Department of Clinical Sciences, Colorado State University, Fort Collins, USA.

Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.

出版信息

Equine Vet J. 2015 Nov;47(6):650-4. doi: 10.1111/evj.12358. Epub 2014 Dec 14.

Abstract

REASONS FOR PERFORMING STUDY

Large colon volvulus results in strangulating obstruction requiring surgical treatment. Duration of this disease prior to surgical treatment is likely to influence survival directly.

OBJECTIVES

The primary objective of this study was to evaluate the influence of duration of large colon volvulus on patient survival to discharge. Relationships between other factors and survival following large colon volvulus were also examined.

STUDY DESIGN

Retrospective case analysis.

METHODS

Medical records of Thoroughbred mares aged ≥2 years undergoing surgical treatment for large colon volvulus between 1 March 1986 and 28 February 2011 were reviewed. Multivariable logistic regression was used to identify influence of duration and other factors on survival to discharge.

RESULTS

Within the study period, 1039 surgeries were performed to correct large colon volvulus in 896 Thoroughbred mares. Median duration of colic signs prior to admission was 2 h (interquartile range [IQR] 1-4 h). Median time from admission to anaesthetic induction was 25 min (IQR 15-45 min). Median surgical time was 70 min (IQR 55-85 min). Primary surgical treatment was simple correction of the large colon volvulus followed by replacement of the colon. The overall survival to discharge was 88%. The final model identified risk factors significantly associated with survival and included colic duration prior to admission, packed cell volume at admission, surgery length, duration of hypotension while under anaesthesia, heart rate 48 h post operatively, post operative manure consistency and days hospitalised.

CONCLUSIONS

Duration of colic prior to admission was statistically associated with patient survival to discharge. Other factors significantly associated with survival in mares with large colon volvulus were related to disease severity and degree of colonic compromise. Mares with large colon volvulus have a good prognosis for recovery with early referral and prompt surgical treatment.

摘要

开展本研究的原因

大肠扭转会导致绞窄性肠梗阻,需要进行手术治疗。这种疾病在手术治疗前的持续时间可能会直接影响生存率。

目的

本研究的主要目的是评估大肠扭转持续时间对患者出院生存率的影响。还研究了其他因素与大肠扭转后生存率之间的关系。

研究设计

回顾性病例分析。

方法

回顾了1986年3月1日至2011年2月28日期间因大肠扭转接受手术治疗的≥2岁纯种母马的病历。采用多变量逻辑回归分析来确定持续时间和其他因素对出院生存率的影响。

结果

在研究期间,对896匹纯种母马进行了1039次手术以纠正大肠扭转。入院前腹痛症状的中位持续时间为2小时(四分位间距[IQR]为1 - 4小时)。从入院到麻醉诱导的中位时间为25分钟(IQR为15 - 45分钟)。中位手术时间为70分钟(IQR为55 - 85分钟)。主要手术治疗是简单纠正大肠扭转,随后将结肠复位。总体出院生存率为88%。最终模型确定了与生存显著相关的危险因素,包括入院前腹痛持续时间、入院时红细胞压积、手术时长、麻醉期间低血压持续时间、术后48小时心率、术后粪便稠度和住院天数。

结论

入院前腹痛持续时间与患者出院生存率在统计学上相关。与大肠扭转母马生存显著相关的其他因素与疾病严重程度和结肠受损程度有关。大肠扭转的母马通过早期转诊和及时手术治疗,恢复预后良好。

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