Wolfman E F
University of California, Davis Medical Center.
Vet Clin North Am Equine Pract. 1989 Aug;5(2):295-307. doi: 10.1016/s0749-0739(17)30590-4.
Operations for intestinal ischemia are frequently done by veterinarians. In equine surgery those conditions commonly producing ischemia are intussusception, volvulus, bowel obstructions, and incarcerated hernias. In an attempt to predict intraoperative bowel viability after the restoration of circulation, a variety of adjuvant methods have been investigated. There is little question that of the techniques currently available, sodium fluorescein injected intravenously approaches the ideal in predicting nonviability in humans and in most animal models. Furthermore, it is safe, takes little operating time, is inexpensive, and is ubiquitously available; in addition, the only special equipment needed is a long-wave ultraviolet lamp. Reliance on this method would seldom result in nonviable bowel being left in situ. Furthermore, the use of fluorescein would minimize the unnecessary resection of viable intestine and, thereby, minimize the postoperative nutritional problems that may occur, especially in equines. The report of Sullins et al questions the accuracy of the fluorescein technique in predicting viability and nonviability in horses and also raises the question as to whether the prediction of viability, after the restoration of intestinal blood flow, also predicts normal intestinal function. Further investigations will be needed to confirm or refute these observations.
兽医经常进行肠道缺血的手术。在马外科手术中，通常导致缺血的情况有肠套叠、肠扭转、肠梗阻和嵌顿疝。为了预测循环恢复后术中肠道的活力，人们研究了多种辅助方法。毫无疑问，在目前可用的技术中，静脉注射荧光素钠在预测人类和大多数动物模型中的无活力方面接近理想状态。此外，它安全、操作时间短、成本低且随处可得；另外，唯一需要的特殊设备是长波紫外线灯。依靠这种方法很少会导致无活力的肠道留在原位。此外，使用荧光素将使对有活力肠道的不必要切除减至最少，从而将术后可能出现的营养问题减至最少，尤其是在马身上。萨林斯等人的报告质疑了荧光素技术在预测马的活力和无活力方面的准确性，还提出了在肠道血流恢复后对活力的预测是否也能预测正常肠道功能的问题。需要进一步的研究来证实或反驳这些观察结果。
