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支气管镜检查联合手术在治疗因植物芒刺迁移继发胸内疾病的犬只中的应用及疗效

Utility of bronchoscopy combined with surgery in the treatment and outcomes of dogs with intrathoracic disease secondary to plant awn migration.

作者信息

Gibson Erin A, Balsa Ingrid M, Mayhew Philipp D, Phillips Kathryn, Giuffrida Michelle A, Culp William T N, Steffey Michele A, Johnson Lynelle R

机构信息

William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis School of Veterinary Medicine, Davis, California.

Department of Surgical and Radiological Science, University of California-Davis School of Veterinary Medicine, Davis, California.

出版信息

Vet Surg. 2019 Oct;48(7):1309-1317. doi: 10.1111/vsu.13287. Epub 2019 Jul 23.

Abstract

OBJECTIVE

To evaluate the diagnostic and therapeutic utility of bronchoscopy in dogs undergoing computed tomography (CT) and surgery for intrathoracic disease (pyothorax and pneumothorax) secondary to migrating plant awns (MPA) and to report outcomes in dogs that did and did not undergo bronchoscopy in addition to CT and surgery.

STUDY DESIGN

Retrospective case series.

ANIMALS

Thirty-seven client-owned dogs.

METHODS

Medical records from 2008 to 2017 were reviewed for dogs with documented MPA in the thoracic cavity treated with CT and surgery with or without bronchoscopy. Information regarding diagnostics, treatments, complications, and outcomes relating to hospitalization was evaluated.

RESULTS

At least one abnormal lung lobe was identified by CT in all dogs. Bronchial abnormalities were identified with bronchoscopy in 21 of 22 dogs (95.4%) with available reports. Agreement between CT and bronchoscopy findings ranged from 50% to 81.8%, depending on lung lobe. Thirty-six dogs had one or more lung lobes surgically removed. Thirty-seven MPA were retrieved via bronchoscopy in 10 of 27 (37%) dogs, and 39 MPA were retrieved at surgery in 26 of 37 (70.3%) dogs. Actinomyces spp. were cultured from surgical samples in 7 of 33 (21.2%) dogs. Thirty-five of 37 (94.6%) dogs survived to discharge.

CONCLUSION

Migrating plant awns were successfully retrieved via bronchoscopy. Agreement between CT findings and bronchoscopy was inconsistent, so there may be roles for both modalities. Short- and long-term survival was excellent in this cohort.

CLINICAL SIGNIFICANCE

Bronchoscopy may allow for diagnostic and therapeutic advantages compared with CT in dogs with endobronchial MPA. Actinomyces spp appear to be variably present in surgically acquired bacterial cultures in dogs with MPA.

摘要

目的

评估支气管镜检查在因迁徙植物芒刺(MPA)导致胸腔疾病(脓胸和气胸)而接受计算机断层扫描(CT)和手术的犬类中的诊断和治疗效用,并报告除CT和手术外接受和未接受支气管镜检查的犬类的预后情况。

研究设计

回顾性病例系列研究。

动物

37只客户拥有的犬。

方法

回顾2008年至2017年期间因胸腔内有记录的MPA而接受CT和手术(有或无支气管镜检查)治疗的犬的病历。评估有关诊断、治疗、并发症以及与住院相关的预后信息。

结果

所有犬通过CT均发现至少一个肺叶异常。在有可用报告的22只犬中的21只(95.4%)通过支气管镜检查发现支气管异常。根据肺叶不同,CT和支气管镜检查结果之间的一致性范围为50%至81.8%。36只犬有一个或多个肺叶被手术切除。27只犬中的10只(37%)通过支气管镜检查取出37根MPA,37只犬中的26只(70.3%)在手术中取出39根MPA。33只犬中的7只(21.2%)手术样本培养出放线菌属。37只犬中的35只(94.6%)存活至出院。

结论

通过支气管镜检查成功取出迁徙植物芒刺。CT检查结果与支气管镜检查之间的一致性不一致,因此两种检查方式可能都有作用。该队列中的短期和长期存活率都很高。

临床意义

与CT相比,支气管镜检查可能使患有支气管内MPA的犬具有诊断和治疗优势。在患有MPA的犬的手术获得的细菌培养物中,放线菌属似乎存在差异。

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