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治疗性非甾体抗炎药应用后导致胃或十二指肠穿孔和继发性感染性腹膜炎。

Gastric or duodenal perforation and secondary septic peritonitis following therapeutic nonsteroidal anti-inflammatory drug administration.

机构信息

Department of Small Animal Clinical Sciences, Veterinary Medical Center, Michigan State University, East Lansing, Michigan, USA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2022 Nov;32(6):764-768. doi: 10.1111/vec.13217. Epub 2022 Jun 16.

DOI:10.1111/vec.13217
PMID:35708902
Abstract

OBJECTIVE

To report which nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with gastric or duodenal perforation (GDP) in dogs presented to a university teaching hospital and to report the frequency of prescription of NSAIDs by the corresponding referring veterinary community during the same time period.

DESIGN

Retrospective cohort study of dogs from January 2007 to March 2020.

SETTING

Single university teaching hospital.

ANIMALS

A total of 30 dogs met inclusion criteria.

MEASUREMENTS AND MAIN RESULTS

Four dogs were administered more than 1 NSAID within 7 days of GDP, 3 dogs received a combination of an NSAID and a corticosteroid, and 1 dog received 2 NSAIDs and a corticosteroid. Four dogs received an overdose of an NSAID. One dog received an overdose of 1 NSAID and received an additional NSAID at the labeled dose within 7 days of GDP. Eighteen dogs received only 1 NSAID at the labeled dose. In these 18 dogs, meloxicam was administered in 44.4% (8/18), firocoxib in 27.8% (5/18), deracoxib in 16.7% (3/18), and piroxicam in 11.1% (2/18). One hundred and sixty surveys on NSAID prescribing practice were returned. Carprofen was the most commonly prescribed NSAID (70.6%), followed by meloxicam (10.6%), deracoxib (8.4%), firocoxib (7.8%), aspirin (1.5%), and other (0.9%).

CONCLUSIONS

NSAID administration, even at labeled doses, appears to be a precipitating factor for GDP. Despite carprofen being the most frequently prescribed NSAID over the study period, no case of GDP received it as a single therapeutic agent. Further prospective evaluation is needed to verify these findings.

摘要

目的

报告在一所大学教学医院就诊的犬胃或十二指肠穿孔(GDP)与哪些非甾体抗炎药(NSAIDs)相关,并报告同期相应转诊兽医社区开具 NSAIDs 的频率。

设计

2007 年 1 月至 2020 年 3 月的犬回顾性队列研究。

地点

单一大学教学医院。

动物

共有 30 只犬符合纳入标准。

测量和主要结果

4 只犬在 GDP 发生前 7 天内接受了超过 1 种 NSAID,3 只犬接受了 NSAID 与皮质类固醇的联合治疗,1 只犬接受了 2 种 NSAID 和皮质类固醇。4 只犬接受了 NSAID 过量治疗。1 只犬接受了 1 种 NSAID 的过量治疗,并在 GDP 发生前 7 天内以标签剂量接受了另一种 NSAID。18 只犬仅以标签剂量接受了 1 种 NSAID。在这 18 只犬中,美洛昔康的使用率为 44.4%(8/18),非诺洛芬的使用率为 27.8%(5/18),德拉考昔的使用率为 16.7%(3/18),吡罗昔康的使用率为 11.1%(2/18)。共收回 160 份关于 NSAID 处方实践的调查问卷。卡洛芬是最常开的 NSAID(70.6%),其次是美洛昔康(10.6%)、德拉考昔(8.4%)、非诺洛芬(7.8%)、阿司匹林(1.5%)和其他(0.9%)。

结论

即使在标签剂量下使用 NSAID,似乎也是 GDP 的一个促成因素。尽管在研究期间卡洛芬是最常开的 NSAID,但没有 GDP 病例仅用它作为单一治疗药物。需要进一步的前瞻性评估来验证这些发现。

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