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11 例犬非甾体抗炎药相关性全层胃肠道溃疡的一期修复。

Primary repair of nonsteroidal anti-inflammatory drug-associated full thickness gastrointestinal ulcers in 11 dogs.

机构信息

Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

出版信息

Vet Surg. 2022 Oct;51(7):1096-1105. doi: 10.1111/vsu.13853. Epub 2022 Jul 22.

DOI:10.1111/vsu.13853
PMID:35866930
Abstract

OBJECTIVE

To report the outcomes of dogs that underwent primary repair of gastroduodenal perforations associated with the administration of nonsteroidal anti-inflammatory drugs (NSAID). A secondary objective was to identify clinicopathological findings that predisposed dogs to postoperative death.

STUDY DESIGN

Retrospective study.

ANIMALS

Eleven dogs with complete gastric or duodenal perforation related to administration of an NSAID that underwent primary surgical repair.

METHODS

Medical records were reviewed for dogs that presented with peritonitis due to a complete gastroduodenal perforation while receiving NSAIDs between November, 2011 and January, 2021. Data collected included patient characteristics, clinical signs, clinicopathological results, surgical details, and postoperative management and outcome.

RESULTS

All dogs were large breeds (mean weight 42 kg; range 22-75 kg), with a mean age of 7.35 years. Nine dogs from a total of 11 (82 %) received a concurrent corticosteroid and NSAID, or a higher dose/frequency/length of NSAID administration than recommended by the manufacturer. All gastroduodenal perforations were found in the upper gastrointestinal tract. Eight of 11 (73%) dogs survived to discharge. The median postoperative duration of follow up was 444 days (range 2-1460 days). No association was detected between ulcer size or location and mortality.

CONCLUSION

Most dogs who underwent primary repair of complete gastroduodenal ulcers survived. Gastroduodenal perforations were generally due to the administration of higher or longer doses of NSAIDs, or concurrent administration of another NSAID or corticosteroid.

CLINICAL SIGNIFICANCE

Primary closure may be associated with a high success rate in dogs with full thickness gastroduodenal ulcers.

摘要

目的

报告因使用非甾体抗炎药(NSAID)而导致胃十二指肠穿孔的犬只接受初次修复的结果。次要目标是确定使犬只易发生术后死亡的临床病理发现。

研究设计

回顾性研究。

动物

11 只因使用 NSAID 而导致完全性胃或十二指肠穿孔并接受初次手术修复的犬。

方法

回顾性分析 2011 年 11 月至 2021 年 1 月期间因接受 NSAID 治疗而出现腹膜炎的犬只,这些犬只的胃十二指肠穿孔完全与 NSAID 相关。收集的数据包括患者特征、临床症状、临床病理结果、手术细节以及术后管理和结果。

结果

所有犬均为大型犬(平均体重 42kg;范围 22-75kg),平均年龄为 7.35 岁。11 只犬中有 9 只(82%)同时接受了皮质类固醇和 NSAID,或接受了高于制造商推荐剂量/频率/时长的 NSAID 治疗。所有胃十二指肠穿孔均发生在上消化道。11 只犬中有 8 只(73%)存活至出院。中位术后随访时间为 444 天(范围 2-1460 天)。未发现溃疡大小或位置与死亡率之间存在关联。

结论

大多数接受初次修复完全性胃十二指肠溃疡的犬只存活。胃十二指肠穿孔通常是由于使用更高或更长剂量的 NSAID,或同时使用另一种 NSAID 或皮质类固醇引起的。

临床意义

初次缝合可能与全层胃十二指肠溃疡犬的高成功率相关。

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