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前瞻性评估留置食管球囊扩张饲管治疗犬猫良性食管狭窄的效果。

Prospective evaluation of an indwelling esophageal balloon dilatation feeding tube for treatment of benign esophageal strictures in dogs and cats.

作者信息

Tan Desmond K, Weisse Chick, Berent Allyson, Lamb Kenneth E

机构信息

Department of Interventional Radiology, Animal Medical Center, New York, New York.

出版信息

J Vet Intern Med. 2018 Mar;32(2):693-700. doi: 10.1111/jvim.15071. Epub 2018 Feb 20.

Abstract

BACKGROUND

Despite multiple dilatation procedures, benign esophageal strictures (BES) remain a recurring cause of morbidity and mortality in dogs and cats.

OBJECTIVE

Investigate the use of an indwelling Balloon Dilatation esophagostomy tube (B-Tube) for treatment of BES in dogs and cats.

ANIMALS

Nine dogs and 3 cats.

METHODS

Animals with BES were recruited for our prospective study. Endoscopic and fluoroscopic evaluation of the esophagus and balloon dilatation were performed under general anesthesia, followed by placement of an indwelling B-Tube. The animals' owners performed twice daily at-home inflations for approximately 6 weeks. Repeat endoscopy was performed before B-Tube removal. Animals were reevaluated for changes in modified dysphagia score (MDS) after B-Tube removal.

RESULTS

The B-Tube management was relatively well tolerated and effective in maintaining dilatation of a BES while in place. These animals underwent a median of 2 anesthetic episodes and were monitored for a median of 472 days (range, 358-1736 days). The mean MDS before treatment was 3.1 ± 0.5/4.0 and final follow-up MDS were significantly (P < .0001) improved at 0.36 ± 0.65/4.0. Eleven of 12 animals (91.7%) had improved MDS at the end of the follow-up period, with 8/12 (66.7%) having an MDS of 0/4, 2/12 (16.7%) an MDS of 1/4, and 1/12 (8.3%) an MDS of 2/4. One dog died.

CONCLUSIONS AND CLINICAL IMPORTANCE

The B-Tube offers an effective, and more economical method, and often decreased anesthetic time to repeated balloon dilatation procedures for the treatment of BES in dogs and cats.

摘要

背景

尽管进行了多次扩张手术,但良性食管狭窄(BES)仍是犬猫发病和死亡的一个反复出现的原因。

目的

研究使用留置球囊扩张食管造口管(B管)治疗犬猫的BES。

动物

9只犬和3只猫。

方法

招募患有BES的动物进行我们的前瞻性研究。在全身麻醉下对食管进行内镜和荧光镜评估以及球囊扩张,随后放置留置B管。动物主人每天在家进行两次充气,持续约6周。在拔除B管前进行重复内镜检查。拔除B管后对动物进行重新评估,观察改良吞咽困难评分(MDS)的变化。

结果

B管管理相对耐受性良好,在留置期间能有效维持BES的扩张。这些动物平均接受了2次麻醉,中位监测时间为472天(范围358 - 1736天)。治疗前平均MDS为3.1±0.5/4.0,最终随访时MDS显著改善(P <.0001),为0.36±0.65/4.0。12只动物中有11只(91.7%)在随访期末MDS有所改善,其中8/12(66.7%)的MDS为0/4,2/12(16.7%)为1/4,1/12(8.3%)为2/4。1只犬死亡。

结论及临床意义

B管为治疗犬猫BES提供了一种有效、更经济的方法,且通常能减少重复球囊扩张手术的麻醉时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ac9/5866955/ef61a38443bf/JVIM-32-693-g001.jpg

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