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犬继发性化脓性腹膜炎初次手术治疗后复发性继发性化脓性腹膜炎危险因素的鉴定

Identification of risk factors for recurrent secondary septic peritonitis following initial surgical treatment of secondary septic peritonitis in dogs.

作者信息

Fink Owen, Buysse Allison, Drobatz Kenneth J, Bentley Adrienne

机构信息

Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, PA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2020 Mar;30(2):213-220. doi: 10.1111/vec.12939. Epub 2020 Feb 24.

Abstract

OBJECTIVES

To report the incidence of and risk factors for development of recurrent secondary septic peritonitis (RSSP) in dogs. To report the outcome of dogs treated surgically for RSSP.

DESIGN

Retrospective study.

SETTING

University teaching hospital.

ANIMALS

One hundred forty-nine client-owned dogs treated surgically for secondary septic peritonitis (SSP).

INTERVENTIONS

None.

MEASUREMENTS AND RESULTS

The medical records database was searched for dogs that underwent surgery to treat SSP. Of 149 dogs that met the inclusion criteria, 15 (10.1%) dogs developed RSSP following surgery and 134 (89.9%) did not. Dogs with RSSP had significantly lower albumin prior to the first surgery to treat secondary septic peritonitis (SPsx1) (median 18 g/L [1.8 g/dL] vs 22 g/L [2.2 g/dL], P = 0.005) and significantly higher PCV prior to SPsx1 (median 52% vs 45%, P = 0.028). Dogs with septic peritonitis of gastrointestinal (GI) origin were significantly more likely to develop recurrent peritonitis than those with sepsis from a non-GI source (odds ratio [OR], 4.4, 95% CI: 0.95-20, P = 0.041). Of dogs with sepsis of GI origin, those with sepsis due to a foreign body were significantly more likely to develop RSSP than those with GI sepsis from a non-foreign body cause (OR, 7.2, 95% CI: 1.6-43, P = 0.0018). Of the 15 dogs in the RSSP group, 8 were euthanized without further treatment. Relaparotomy was performed in the remaining 7 cases; 3 of these (42.9%) survived.

CONCLUSIONS

There was a 10.1% rate of RSSP following SPsx1. Preoperative albumin was significantly lower and preoperative PCV was significantly higher in dogs that developed recurrence. Dogs with GI sepsis were at increased risk of recurrence and, among dogs with GI sepsis, the presence of a foreign body was an additional risk factor for recurrence.

摘要

目的

报告犬复发性继发性化脓性腹膜炎(RSSP)的发病率及危险因素。报告接受手术治疗的犬患RSSP的预后情况。

设计

回顾性研究。

地点

大学教学医院。

动物

149只接受手术治疗继发性化脓性腹膜炎(SSP)的客户拥有的犬。

干预措施

无。

测量与结果

在病历数据库中搜索接受手术治疗SSP的犬。在符合纳入标准的149只犬中,15只(10.1%)犬术后发生RSSP,134只(89.9%)未发生。发生RSSP的犬在首次治疗继发性化脓性腹膜炎手术(SPsx1)前白蛋白水平显著更低(中位数18g/L[1.8g/dL]对22g/L[2.2g/dL],P=0.005),且在SPsx1前红细胞压积显著更高(中位数52%对45%,P=0.028)。胃肠道(GI)源性化脓性腹膜炎的犬比非GI源性脓毒症的犬发生复发性腹膜炎的可能性显著更高(比值比[OR],4.4,95%可信区间:0.95 - 20,P=0.041)。在GI源性脓毒症的犬中,因异物导致脓毒症的犬比非异物原因导致GI脓毒症的犬发生RSSP的可能性显著更高(OR,7.2,95%可信区间:1.6 - 43,P=0.0018)。在RSSP组的15只犬中,8只未进一步治疗即实施安乐死。其余7例进行了再次剖腹手术;其中3只(42.9%)存活。

结论

SPsx1后RSSP发生率为10.1%。发生复发的犬术前白蛋白显著更低,术前红细胞压积显著更高。GI脓毒症的犬复发风险增加,且在GI脓毒症的犬中,异物的存在是复发的另一个危险因素。

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