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胸腰椎急性非压迫性髓核脱出犬尿失禁或粪失禁的预测因子。

Predictors of urinary or fecal incontinence in dogs with thoracolumbar acute non-compressive nucleus pulposus extrusion.

机构信息

Department of Neurology/Neurosurgery, Centre for Small Animal Studies, Animal Health Trust, Newmarket, Suffolk, UK.

Neurology/Neurosurgery Service, Willows Veterinary Centre and Referral Services, Solihull, UK.

出版信息

J Vet Intern Med. 2019 Nov;33(6):2693-2700. doi: 10.1111/jvim.15626. Epub 2019 Oct 31.

Abstract

BACKGROUND

Urinary (UI) and fecal (FI) incontinence occur in up to 7.5% and 32% of dogs, respectively, after thoracolumbar acute noncompressive nucleus pulposus extrusion (ANNPE).

HYPOTHESES/OBJECTIVES: To investigate clinical, diagnostic, and therapeutic predictors of UI and FI in dogs with ANNPE affecting the T3-L3 spinal cord segments.

ANIMALS

Hundred and eighty-seven dogs with T3-L3 ANNPE diagnosed based on clinical and MRI findings.

METHODS

Multicenter retrospective study. Data were obtained from medical records and telephone questionnaires and analyzed by logistic regression.

RESULTS

UI and FI were reported in 17 (9.1%) and 44 (23.5%) dogs, respectively. Paraplegic dogs were 3 times (95% CI = 1.25, 10.87) more likely to develop UI (P = .018) and 4 times (95% CI = 1.94, 12.56) more likely to develop FI (P = .001) compared to nonparaplegic dogs. Dogs with an intramedullary hyperintensity greater than 40% of the cross-sectional area of the spinal cord at the same level on transverse T2-weighted MRI images were 4 times more likely to develop UI (95% CI = 1.04, 21.72; P = .045) and FI (95% CI = 1.56, 10.39; P = .004) compared to dogs with smaller lesions. FI was 3 times (95% CI = 1.41, 7.93) more likely in dogs that were not treated with nonsteroidal anti-inflammatory drugs (NSAIDs) after diagnosis compared to dogs administered NSAIDs (P = .006) and 2 times (95% CI = 1.12, 5.98) more likely in dogs presented with clinical signs compatible with spinal shock compared to dogs without (P = .026).

CONCLUSION AND CLINICAL IMPORTANCE

The identification of clinical, diagnostic, and therapeutic predictors of UI and FI in dogs with T3-L3 ANNPE can help to approach these autonomic dysfunctions occurring after spinal cord injury.

摘要

背景

犬胸腰段急性非压迫性髓核突出(ANNPE)后,分别有高达 7.5%和 32%的犬出现尿失禁(UI)和粪便失禁(FI)。

假设/目的:本研究旨在探讨影响 T3-L3 脊髓段的 ANNPE 犬发生 UI 和 FI 的临床、诊断和治疗预测因素。

动物

187 只被诊断为 T3-L3 ANNPE 的犬。

方法

多中心回顾性研究。数据来自病历和电话问卷调查,并通过逻辑回归进行分析。

结果

UI 和 FI 分别在 17 只(9.1%)和 44 只(23.5%)犬中被报道。与非截瘫犬相比,截瘫犬发生 UI 的可能性高 3 倍(95%CI=1.25,10.87;P=.018),发生 FI 的可能性高 4 倍(95%CI=1.94,12.56;P=.001)。与脊髓内横断 T2 加权 MRI 图像上同一水平脊髓截面积大于 40%的高信号相比,脊髓内横断 T2 加权 MRI 图像上脊髓截面积大于 40%的犬发生 UI 的可能性高 4 倍(95%CI=1.04,21.72;P=.045)和 FI 的可能性高 4 倍(95%CI=1.56,10.39;P=.004)。与诊断后未接受非甾体抗炎药(NSAIDs)治疗的犬相比,接受 NSAIDs 治疗的犬发生 FI 的可能性高 3 倍(95%CI=1.41,7.93;P=.006),与无脊髓休克临床症状的犬相比,有脊髓休克临床症状的犬发生 FI 的可能性高 2 倍(95%CI=1.12,5.98;P=.026)。

结论和临床意义

识别 T3-L3 ANNPE 犬发生 UI 和 FI 的临床、诊断和治疗预测因素,有助于处理脊髓损伤后出现的这些自主神经功能障碍。

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本文引用的文献

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Revisit Spinal Shock: Pattern of Reflex Evolution during Spinal Shock.重新审视脊髓休克:脊髓休克期间反射演变模式
Korean J Neurotrauma. 2018 Oct;14(2):47-54. doi: 10.13004/kjnt.2018.14.2.47. Epub 2018 Oct 31.
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RhoA/Rho kinase in spinal cord injury.脊髓损伤中的RhoA/ Rho激酶
Neural Regen Res. 2016 Jan;11(1):23-7. doi: 10.4103/1673-5374.169601.

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