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犬胸部咬伤伤口:123例病例的回顾性研究(2003 - 2016年)

Thoracic dog bite wounds in dogs: A retrospective study of 123 cases (2003-2016).

作者信息

Frykfors von Hekkel Anna K, Pegram Camilla, Halfacree Zoë J

机构信息

Soft Tissue Surgery Service, Clinical Science and Services, Royal Veterinary College, London, United Kingdom.

Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom.

出版信息

Vet Surg. 2020 May;49(4):694-703. doi: 10.1111/vsu.13402. Epub 2020 Feb 20.

DOI:10.1111/vsu.13402
PMID:32077513
Abstract

OBJECTIVE

To report the clinical, radiographic, and surgical findings and determine prognostic factors for outcome in dogs with thoracic dog bite wounds.

STUDY DESIGN

Retrospective study.

ANIMALS

Client-owned dogs (n = 123).

METHODS

Medical records of dogs with thoracic dog bite wounds between October 2003 to July 2016 were reviewed for presenting findings, management, and outcomes. Standard wound management included debridement and sterile probing, extending the level of exploration to the depth of the wound. Univariable and multivariable binary logistic regression were used to assess risk factors for exploratory thoracotomy, lung lobectomy, and mortality.

RESULTS

Twenty-five dogs underwent exploratory thoracotomy, including lung lobectomy in 12 of these dogs. Presence of pneumothorax (odds ratio [OR] 25.4, confidence interval (CI) 5.2-123.2, P < .001), pseudo-flail chest (OR 15.8, CI 3.2-77.3, P = .001), or rib fracture (OR 11.2, CI 2.5-51.2, P = .002) was associated with increased odds of undergoing exploratory thoracotomy. Presence of pleural effusion (OR 12.1, CI 1.2-120.2, P = .033) and obtaining a positive bacterial culture (OR 23.4, CI 1.6-337.9, P = .021) were associated with increased odds of mortality. The level of wound management correlated with the length of hospitalization (Spearman rank order correlation = 0.52, P < .001) but was not associated with mortality.

CONCLUSION

Dogs that sustained pseudo-flail chest, rib fracture, or pneumothorax were more likely to undergo exploratory thoracotomy. Nonsurvival was more likely in dogs with pleural effusion or positive bacterial culture.

CLINICAL SIGNIFICANCE

Presence of pseudo-flail, rib fracture, or pneumothorax should raise suspicion of intrathoracic injury. Strong consideration should be given to radiography, surgical exploration, and debridement of all thoracic dog bite wounds.

摘要

目的

报告犬胸部咬伤的临床、影像学和手术发现,并确定其预后因素。

研究设计

回顾性研究。

动物

客户拥有的犬只(n = 123)。

方法

回顾2003年10月至2016年7月期间患有胸部犬咬伤的犬只的病历,以了解其临床表现、治疗和预后情况。标准伤口处理包括清创和无菌探查,将探查深度延伸至伤口深处。采用单变量和多变量二元逻辑回归分析评估开胸探查、肺叶切除和死亡的危险因素。

结果

25只犬接受了开胸探查,其中12只进行了肺叶切除。气胸(优势比[OR] 25.4,置信区间[CI] 5.2 - 123.2,P <.001)、假性连枷胸(OR 15.8,CI 3.2 - 77.3,P =.001)或肋骨骨折(OR 11.2,CI 2.5 - 51.2,P =.002)与开胸探查几率增加相关。胸腔积液(OR 12.1,CI 1.2 - 120.2,P =.033)和细菌培养阳性(OR 23.4,CI 1.6 - 337.9,P =.021)与死亡几率增加相关。伤口处理水平与住院时间相关(Spearman等级相关系数 = 0.52,P <.001),但与死亡率无关。

结论

发生假性连枷胸、肋骨骨折或气胸的犬更有可能接受开胸探查。胸腔积液或细菌培养阳性的犬死亡可能性更大。

临床意义

出现假性连枷胸、肋骨骨折或气胸应怀疑有胸内损伤。对于所有犬胸部咬伤伤口,应高度考虑进行放射检查、手术探查和清创。

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