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猫良性输尿管梗阻:医疗管理的结果。

Benign ureteral obstruction in cats: Outcome with medical management.

机构信息

Department of Clinical Sciences, School of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada.

出版信息

J Vet Intern Med. 2023 May-Jun;37(3):1047-1058. doi: 10.1111/jvim.16709. Epub 2023 Apr 19.

Abstract

BACKGROUND

Limited information is available regarding the outcome of medical management (MM) of benign ureteral obstruction in cats (BUO).

HYPOTHESIS

Describe clinical characteristics and outcome of MM of BUO.

ANIMALS

Seventy-two client-owned cats with 103 obstructed kidneys.

METHODS

Medical records of cats diagnosed with BUO between 2010 and 2021 that received >72 hours of MM were retrospectively reviewed. Clinical data, treatment, and outcome were reviewed. Outcome was classified as success, partial success, or failure based on ultrasound findings. Factors associated with outcome were assessed.

RESULTS

Seventy-two cats with 103 obstructed kidneys were enrolled. The causes of obstruction were uroliths in 73% (75/103), strictures in 13.5% (14/103), and pyonephrosis in 13.5% (14/103) of affected kidneys. Median serum creatinine concentration at presentation was 4.01 mg/dL (range, 1.30-21.3 mg/dL). Outcome after MM was considered a success in 30% (31/103), partial success in 13% (13/103), and failure in 57% (59/103) of kidneys. Success was reported in 23% (17/75) of kidneys with uroliths, 50% (7/14) with pyonephrosis, and 50% (7/14) with strictures. Median time to a successful outcome was 16 days (range, 3-115 days). Distal and smaller uroliths (median length, 1.85 mm) were significantly associated with success (P = .05 and P = .01, respectively). Median survival times were 1188 days (range, 60-1700 days), 518 days (range, 7-1812 days), and 234 days (range, 4-3494 days) for success, partial success, and failure, respectively.

CONCLUSIONS AND CLINICAL IMPORTANCE

We found a higher success rate for MM of BUO than previously reported. Smaller distal uroliths (<1-2 mm) were more likely to pass.

摘要

背景

关于猫良性输尿管梗阻(BUO)的医学治疗(MM)的结果,相关信息有限。

假设

描述 MM 治疗 BUO 的临床特征和结果。

动物

72 只患有 103 个梗阻肾脏的患宠猫。

方法

回顾性分析 2010 年至 2021 年间诊断为 BUO 并接受 >72 小时 MM 治疗的猫的病历。评估临床数据、治疗和结果。根据超声结果,将结果分类为成功、部分成功或失败。评估与结果相关的因素。

结果

纳入了 72 只患有 103 个梗阻肾脏的猫。梗阻的原因是结石 73%(75/103),狭窄 13.5%(14/103),积脓 13.5%(14/103)。就诊时血清肌酐浓度中位数为 4.01mg/dL(范围,1.30-21.3mg/dL)。MM 治疗后的结果,30%(31/103)的肾脏被认为是成功的,13%(13/103)是部分成功的,57%(59/103)是失败的。结石组的成功比例为 23%(17/75),积脓组为 50%(7/14),狭窄组为 50%(7/14)。成功的中位时间为 16 天(范围,3-115 天)。远端和较小的结石(中位长度 1.85mm)与成功显著相关(P=0.05 和 P=0.01)。成功、部分成功和失败的中位生存时间分别为 1188 天(范围,60-1700 天)、518 天(范围,7-1812 天)和 234 天(范围,4-3494 天)。

结论和临床意义

我们发现 MM 治疗 BUO 的成功率高于之前的报告。较小的远端结石(<1-2mm)更有可能通过。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6c4/10229371/8eb13140e588/JVIM-37-1047-g001.jpg

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