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跗关节急性软组织创伤马匹的临床表现、治疗及预后的描述性研究及其与滑膜受累的关系

A Descriptive Study of the Clinical Presentation, Management, and Outcome of Horses with Acute Soft Tissue Trauma of the Tarsus and the Association with Synovial Involvement.

作者信息

Vajs Taja, Nekouei Omid, Biermann Nora M

机构信息

University Equine Hospital, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna 1210, Austria.

Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong 999077, China.

出版信息

Animals (Basel). 2022 Feb 21;12(4):524. doi: 10.3390/ani12040524.

Abstract

The tarsus is one of the most common areas of traumatic injury with associated synovial involvement (SI) in horses. The aim of this retrospective study was to describe the clinical presentation, diagnostic procedures, management (emphasizing the type, duration, and route of antimicrobial administration), and outcome of cases with acute soft tissue trauma to the tarsal region. The presenting clinical features, the results of diagnostic modalities, and the initial response to therapy were assessed for their usefulness to predict SI. Medical records of 72 cases were included and SI was diagnosed in 34 cases (47.2%). Increased synovial effusion, lameness on admission (OR = 4.1; 95%CI 1.0-16.4), persistent lameness (OR = 5.7; 95%CI 1.8-17.9), increased blood SAA values (≥200 mg/L) from initial to second measurement (OR = 4.3; 95%CI 1.2-15.5), and wound location on the plantar/plantarolateral/plantaromedial compared to the lateral aspect of the tarsus (OR = 7.0; 95%CI 1.6-30.9) were associated with SI. Radiographs, ultrasonography, and the use of pressure testing when a wound was present proved to be useful in correctly diagnosing SI. The median duration of systemic antimicrobial administration was 8 (IQR: 5 to 9) days and most horses received local antimicrobial therapy. This study highlights several relevant clinical features and their association with SI and emphasizes the usefulness of local antimicrobial therapy in these cases.

摘要

跗关节是马创伤性损伤最常见的部位之一,常伴有滑膜受累(SI)。这项回顾性研究的目的是描述跗关节区域急性软组织创伤病例的临床表现、诊断程序、治疗(重点是抗菌药物的类型、持续时间和给药途径)及预后。评估了呈现的临床特征、诊断方法的结果以及对治疗的初始反应,以判断它们对预测滑膜受累的有用性。纳入了72例病例的医疗记录,其中34例(47.2%)被诊断为滑膜受累。滑膜积液增加、入院时跛行(比值比=4.1;95%置信区间1.0-16.4)、持续性跛行(比值比=5.7;95%置信区间1.8-17.9)、首次测量到第二次测量时血液SAA值升高(≥200mg/L)(比值比=4.3;95%置信区间1.2-15.5)以及与跗关节外侧相比伤口位于跖侧/跖外侧/跖内侧(比值比=7.0;95%置信区间1.6-30.9)均与滑膜受累相关。X线片、超声检查以及伤口存在时进行压力测试被证明对正确诊断滑膜受累很有用。全身抗菌药物给药的中位持续时间为8(四分位间距:5至9)天,大多数马匹接受了局部抗菌治疗。本研究突出了几个相关的临床特征及其与滑膜受累的关联,并强调了局部抗菌治疗在这些病例中的有用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10b0/8868076/103f697d229e/animals-12-00524-g001.jpg

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