Espinosa Pablo, Le Jeune Sarah S, Cenani Alessia, Kass Philip H, Brosnan Robert J
William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, California.
Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
Vet Surg. 2017 Apr;46(3):345-353. doi: 10.1111/vsu.12618. Epub 2017 Feb 2.
To determine if preoperative and intraoperative physiologic variables, and surgical factors correlate with survival to anesthetic recovery or hospital discharge, repeat celiotomy, and postoperative nasogastric intubation (NGT) in horses undergoing exploratory celiotomy for small intestinal (SI) strangulating lesions.
Retrospective case series.
Horses that had surgical correction of SI strangulating lesions (n = 258).
Medical records (January 2000-December 2014) of horses that had surgical correction of SI strangulating lesions were reviewed. Data collection included signalment, preoperative physical examination variables, hematologic values, presence of gastric reflux, peritoneal fluid analysis, intraoperative physiologic variables, intraoperative findings/treatments, and arterial blood gas values. Risk factors for survival to anesthetic recovery and hospital discharge were determined using exact logistic regression.
Survival to anesthetic recovery was 76% and survival to discharge after anesthetic recovery was 79%. The difference between abdominal and peripheral lactate concentrations and intraoperative tachycardia were associated with not surviving to anesthetic recovery or hospital discharge. Intraoperative hypotension, hypocapnia, and low intraoperative packed cell volume (PCV) were negative predictors of survival to anesthetic recovery. Low intraoperative PCV was also associated with NGT postoperatively. Performing resection-anastomosis and jejunocecostomy were associated with repeat celiotomy and with not surviving to hospital discharge.
Several hematological and cardiorespiratory variables show good correlation with short-term survival in horses undergoing surgery for SI strangulating lesions. These variables are easily measured and could be useful for prognosticating survival in horses presenting with SI strangulating lesions.
确定接受小肠绞窄性病变探查性剖腹术的马匹，其术前和术中生理变量以及手术因素与麻醉恢复或出院存活、再次剖腹术和术后鼻胃插管（NGT）之间是否存在关联。
回顾性病例系列研究。
接受小肠绞窄性病变手术矫正的马匹（n = 258）。
回顾2000年1月至2014年12月接受小肠绞窄性病变手术矫正的马匹的病历。数据收集包括特征、术前体格检查变量、血液学值、胃反流情况、腹腔液分析、术中生理变量、术中发现/治疗情况以及动脉血气值。使用精确逻辑回归确定麻醉恢复和出院存活的危险因素。
麻醉恢复的存活率为76%，麻醉恢复后出院的存活率为79%。腹部和外周乳酸浓度差异以及术中心动过速与麻醉恢复或出院未存活相关。术中低血压、低碳酸血症和术中低红细胞压积（PCV）是麻醉恢复存活的负性预测因素。术中低PCV也与术后NGT相关。进行切除吻合术和空肠回肠吻合术与再次剖腹术以及出院未存活相关。
在接受小肠绞窄性病变手术的马匹中，几个血液学和心肺变量与短期存活显示出良好的相关性。这些变量易于测量，可能有助于预测出现小肠绞窄性病变的马匹的存活情况。
