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65匹驹(2010 - 2015年)脐部感染的手术治疗及长期预后

Surgical management and long-term outcome of umbilical infection in 65 foals (2010-2015).

作者信息

Oreff Gil L, Tatz Amos J, Dahan Roee, Segev Gilad, Berlin Dalia, Kelmer Gal

机构信息

Department of Large Animal, Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.

Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Israel.

出版信息

Vet Surg. 2017 Oct;46(7):962-970. doi: 10.1111/vsu.12695. Epub 2017 Aug 3.

Abstract

OBJECTIVE

To report the short- and long-term outcomes of surgical management of umbilical infection in foals.

STUDY DESIGN

Retrospective case series.

ANIMALS

Foals (n = 65).

METHODS

Medical records (2010-2015) of foals up to 1 month of age, surgically treated for an umbilical infection were reviewed. Short-term (at the time of discharge from hospital) and long-term (1 year after surgery) survival rates were obtained. Clinical variables influencing survival were assessed. Chi-square or Fisher's exact test were used to evaluate the relationship between the data retrieved and outcome. P ≤ .05 was considered statistically significant.

RESULTS

Sixty-five foals were included in the study, representing 17.2% of all foals admitted to the hospital. Fifty foals were discharged from hospital (77%) and 43 foals (66%) were alive 1 year after surgery. Lower long-term survival rates were associated with: younger age at presentation, septic joints, multiple pathologies, higher creatinine level, higher heart rate, umbilical infection diagnosed at the hospital rather than prior to referral, prolonged hospitalization, longer period between arrival and surgery, and postoperative complications. The most common surgical findings were urachal enlargement followed by right arterial enlargement.

CONCLUSION

Younger foals with worse systemic condition and concurrent disorders are at higher risk for treatment failure. Early diagnosis improves the outcome. Surgical treatment yields good results and should be considered upon diagnosis, after taking into account the clinical situation.

CLINICAL SIGNIFICANCE

Based on the results of this study, diagnosis and surgical management of umbilical infection in neonatal foals should be performed as early as possible, and a good outcome can be expected after surgery.

摘要

目的

报告幼驹脐部感染手术治疗的短期和长期结果。

研究设计

回顾性病例系列研究。

动物

幼驹(n = 65)。

方法

回顾了2010年至2015年1月龄及以下因脐部感染接受手术治疗的幼驹的病历。获得短期(出院时)和长期(术后1年)生存率。评估影响生存的临床变量。采用卡方检验或Fisher精确检验评估所检索数据与结果之间的关系。P≤0.05被认为具有统计学意义。

结果

65匹幼驹纳入本研究,占所有入院幼驹的17.2%。50匹幼驹出院(77%),43匹幼驹(66%)术后1年存活。较低的长期生存率与以下因素相关:就诊时年龄较小、化脓性关节、多种病症、肌酐水平较高、心率较高、在医院而非转诊前诊断为脐部感染、住院时间延长、到达与手术之间的间隔时间较长以及术后并发症。最常见的手术发现是脐尿管扩大,其次是右侧动脉扩大。

结论

全身状况较差且并发疾病的幼驹治疗失败风险较高。早期诊断可改善预后。手术治疗效果良好,在考虑临床情况后,一经诊断就应考虑进行手术治疗。

临床意义

基于本研究结果,新生幼驹脐部感染的诊断和手术治疗应尽早进行,术后有望获得良好预后。

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