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评估包扎对奶牛足底溃疡愈合效果的随机临床试验。

Randomized clinical trial evaluating the effect of bandaging on the healing of sole ulcers in dairy cattle.

作者信息

Klawitter Marcus, Braden Theo Broderick, Müller Kerstin Elisabeth

机构信息

Clinic for Ruminants and Swine, Freie Universität Berlin, Berlin, Germany.

MSSW, School of Medicine, UW-Madison, Madison, WI 53706, United States.

出版信息

Vet Anim Sci. 2019 Aug 28;8:100070. doi: 10.1016/j.vas.2019.100070. eCollection 2019 Dec.

Abstract

This randomized clinical trial investigated the effect of bandaging on 56 uncomplicated sole ulcers (SU) among a sample of 52 dairy cows. Following therapeutic hoof trimming and povidone-iodine treatment, all cows received a wooden block on the unaffected claw and were randomly assigned into either a bandaged or non-bandaged group. The bandaging process was standardized and applied by the same veterinarian. Wound size and locomotion were measured weekly. Overall, 19 of 32 SU (59.4%) in the non-bandaged group were healed at week 4 compared to 7 of 24 ulcers (29.2%) in the bandaged group. Healing was significantly higher for non-bandaged than bandaged SU ( = 0.024). Bandaging had no effect on locomotion ( = 0.9). Cows with a lower locomotion (Sprecher 1 + 2) had significantly smaller lesion sizes (median lesion size, 0.5 cm², IQR = 0.21 to 0.92 cm²) than animals with locomotion score 3-5 (median lesion size, 0.9 cm², IQR = 0.42 to 1.81 cm²;  < 0.001). A multivariate cox proportional hazard regression indicated that bandaging and parity had a significant effect on healing. Specifically, bandaged SU had a significantly lower hazard ratio (HR) to cure compared to non-bandaged SU (HR = 0.32;  = 0.01; 95% CI = 0.13 to 0.78). Furthermore, cows with parity ≥3 had a significantly higher HR to cure compared to cows in their first lactation (HR = 2.73;  = 0.025; 95% CI = 1.14 to 6.56).

摘要

这项随机临床试验研究了包扎对52头奶牛样本中56处单纯性蹄底溃疡(SU)的影响。在进行治疗性蹄修剪和聚维酮碘治疗后,所有奶牛在未受影响的蹄爪上放置一个木块,并被随机分为包扎组或非包扎组。包扎过程由同一位兽医进行标准化操作。每周测量伤口大小和运动能力。总体而言,非包扎组32处SU中有19处(59.4%)在第4周愈合,而包扎组24处溃疡中有7处(29.2%)愈合。非包扎的SU愈合率显著高于包扎的SU(P = 0.024)。包扎对运动能力没有影响(P = 0.9)。运动能力较低(Sprecher 1 + 2)的奶牛病变大小(中位数病变大小,0.5 cm²,IQR = 0.21至0.92 cm²)明显小于运动评分3 - 5的动物(中位数病变大小,0.9 cm²,IQR = 0.42至1.81 cm²;P < 0.001)。多变量考克斯比例风险回归表明,包扎和胎次对愈合有显著影响。具体而言,与非包扎的SU相比,包扎的SU治愈的风险比(HR)显著更低(HR = 0.32;P = 0.01;95% CI = 0.13至0.78)。此外,与头胎奶牛相比,胎次≥3的奶牛治愈的HR显著更高(HR = 2.73;P = 0.025;95% CI = 1.14至6.56)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8187/7386733/b54d27f70a4d/gr1.jpg

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