Sala Giulia, Boccardo Antonio, Fantinato Eleonora, Coppoletta Eleonora, Bronzo Valerio, Riccaboni Pietro, Belloli Angelo Giovanni, Pravettoni Davide
Dipartimento di Medicina Veterinaria, Universita degli Studi di Milano, Lodi, Italy.
Centro Clinico-Veterinario e Zootecnico-Sperimentale, Universita degli Studi di Milano, Lodi, Lombardy, Italy.
Vet Rec Open. 2019 Feb 18;6(1):e000254. doi: 10.1136/vetreco-2017-000254. eCollection 2019.
Iatrogenic diseases in veterinary medicine are often related to malpractice or lack of skill. For this retrospective study, 4262 clinical records of cattle admitted to the veterinary teaching hospital of the University of Milan between 2005 and 2017 were analysed, and 121 cases (2.8 per cent), referred for an iatrogenic-related disease, were selected. The findings showed that iatrogenic diseases were more often caused by farmers (92.6per cent) than by bovine practitioners (7.4 per cent). Iatrogenic diseases were caused mainly by the improper administration of drugs (43.0 per cent), forced extraction during calving (19.8 per cent), forced milk or colostrum feeding, which was often performed by awkward administration using a nipple bottle (14.9 per cent) or by oral oesophageal tubing (15.7 per cent). Moreover, farmers often performed medical, nursing and zootechnical procedures without adequate training. The role of the practitioner is fundamental in farmer education. Clinicians, especially in some professional branches such as neonatology, should not delegate medical procedures to untrained farmers. Effective tutoring and good communication with farmers play a key role in dairy herd health and consequently in public health. This then can lead to a decrease in improper drug administration, the prevention of antibiotic resistance and the reduction of treatment costs.
兽医学中的医源性疾病通常与医疗失误或技术欠缺有关。在这项回顾性研究中,分析了2005年至2017年间米兰大学兽医学院收治的4262份牛的临床记录,并选取了121例(2.8%)因医源性相关疾病前来就诊的病例。研究结果表明,医源性疾病更多是由养殖户(92.6%)而非牛医(7.4%)造成的。医源性疾病主要由药物使用不当(43.0%)、产犊时强行助产(19.8%)、强行挤奶或喂初乳(常因使用奶瓶操作笨拙导致,占14.9%,或通过口腔食管插管导致,占15.7%)引起。此外,养殖户常常在未接受充分培训的情况下就进行医疗、护理和畜牧技术操作。兽医在养殖户教育中起着至关重要的作用。临床医生,尤其是在新生儿学等一些专业领域,不应将医疗操作委托给未经培训的养殖户。有效的指导以及与养殖户的良好沟通对奶牛群健康乃至公共卫生都起着关键作用。这进而可以减少药物使用不当的情况,预防抗生素耐药性,并降低治疗成本。