Wilson David, Monnet Eric
J Am Vet Med Assoc. 2016 Jan 15;248(2):188-94. doi: 10.2460/javma.248.2.188.
To identify risk factors for the development of aspiration pneumonia after unilateral arytenoid lateralization in dogs with laryngeal paralysis.
Retrospective case series.
232 client-owned dogs with a diagnosis of laryngeal paralysis treated with left-sided unilateral arytenoid lateralization.
Medical records were reviewed. Signalment, medical history, surgical complications, and outcome data were collected. Follow-up was performed via review of medical records and by telephone interview with the owner, referring veterinarian, or both.
At the 1-, 3-, and 4-year follow-up periods, aspiration pneumonia occurred in 18.6%, 31.8%, and 31.8% of dogs, respectively. The 1-, 3-, and 4-year survival rates for dogs with postoperative aspiration pneumonia were 83.1%, 51.5%, and 25.8%, respectively. None of the dogs with aspiration pneumonia before surgery developed clinical signs of aspiration pneumonia after surgery. Postoperative megaesophagus (hazard ratio [HR], 2.58; 95% confidence interval [CI], 1.56 to 3.93) and postoperative administration of opioid analgesics prior to discharge (HR, 1.69; 95% CI, 1.12 to 2.80) were significant risk factors for the long-term development of aspiration pneumonia in this study. Perioperative metoclopramide administration did not significantly decrease the risk for development of aspiration pneumonia (HR, 0.94; 95% CI, 0.67 to 1.37).
In the present study, aspiration pneumonia was the most commonly reported postoperative complication of unilateral lateralization in dogs treated for laryngeal paralysis; however, preexisting aspiration pneumonia was not associated with an increased risk for development of aspiration pneumonia after surgery. Megaesophagus was identified as an important risk factor for eventual development of aspiration pneumonia. Administration of an opioid analgesic may increase the risk of aspiration pneumonia in dogs treated surgically for laryngeal paralysis.
确定喉麻痹犬单侧杓状软骨外侧化术后发生误吸性肺炎的危险因素。
回顾性病例系列研究。
232只确诊为喉麻痹并接受左侧单侧杓状软骨外侧化治疗的客户拥有的犬。
查阅病历。收集信号、病史、手术并发症及结局数据。通过查阅病历及与犬主、转诊兽医电话访谈进行随访。
在1年、3年和4年随访期，分别有18.6%、31.8%和31.8%的犬发生误吸性肺炎。术后发生误吸性肺炎犬的1年、3年和4年生存率分别为83.1%、51.5%和25.8%。术前有误吸性肺炎的犬术后均未出现误吸性肺炎的临床症状。术后巨食管（风险比[HR]，2.58；95%置信区间[CI]，1.56至3.93）及出院前术后使用阿片类镇痛药（HR，1.69；95%CI，1.12至2.80）是本研究中误吸性肺炎长期发生的显著危险因素。围手术期使用甲氧氯普胺并未显著降低发生误吸性肺炎的风险（HR，0.94；95%CI，0.67至1.37）。
在本研究中，误吸性肺炎是接受喉麻痹治疗的犬单侧外侧化术后最常报告的并发症；然而，术前存在的误吸性肺炎与术后发生误吸性肺炎的风险增加无关。巨食管被确定为最终发生误吸性肺炎的重要危险因素。对接受喉麻痹手术治疗的犬使用阿片类镇痛药可能会增加发生误吸性肺炎的风险。
