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管囊造口术在治疗腰椎 3 段脊髓以上的椎间盘突岀和缺血性脊髓病的犬中,对尿液流出管理有效:61 只狗(2018-2022 年)。

Tube cystostomy is effective for urinary outflow management in dogs with intervertebral disk extrusion and ischemic myelopathy cranial to the L3 spinal cord segment: 61 dogs (2018-2022).

出版信息

J Am Vet Med Assoc. 2023 Aug 16;261(12):1-7. doi: 10.2460/javma.23.06.0347. Print 2023 Dec 1.

Abstract

OBJECTIVE

To describe the application and owner experience of tube cystostomy for management of upper motor neuron urinary bladder dysfunction secondary to intervertebral disk extrusion (IVDE) or ischemic myelopathy, and to report complications associated with cystostomy tube management.

ANIMALS

61 dogs.

CLINICAL PRESENTATION

Medical records of dogs with IVDE or ischemic myelopathy cranial to the L3 spinal cord segment that underwent tube cystostomy placement via a short, caudal ventral midline celiotomy were reviewed. Days from tube placement to hospital discharge, days from placement to tube removal, and complications were recorded. An owner questionnaire was distributed to ascertain ease of use and perceived time commitment.

RESULTS

58 dogs were diagnosed with IVDE, and 3 dogs were diagnosed with ischemic myelopathy. The modal neurologic grade at cystostomy tube placement was 4 (range, 3 to 5). The median number of days from cystostomy tube placement to hospital discharge was 1 (range, 0 to 3). Follow-up data was available for 56 dogs. The median number of days from cystostomy tube placement until removal was 19 (range, 3 to 74). Fifteen minor and 6 severe postoperative complications were reported, mainly inadvertent removal (n = 11) and peristomal urine leakage (6). Twenty-seven owners responded to the questionnaire and primarily reported that cystostomy tube use was easy (22/27) and perceived time commitment was low or minimal (20/27).

CLINICAL RELEVANCE

Tube cystostomy facilitates early hospital discharge and allows at-home, extended urinary management in dogs recovering from upper motor neuron urinary bladder dysfunction secondary to IVDE or ischemic myelopathy. This technique is simple for owners to use.

摘要

目的

描述在因椎间盘突出(IVDE)或缺血性脊髓病导致的上运动神经元性膀胱功能障碍时应用和使用造瘘管的情况,并报告与造瘘管管理相关的并发症。

动物

61 只狗。

临床症状

对接受经短的尾部腹侧正中剖腹术进行造瘘管置管术的 L3 脊髓段以上存在 IVDE 或缺血性脊髓病的狗的病历进行回顾。记录了从置管到出院的天数、从置管到拔管的天数和并发症。发放了一份主人调查问卷,以确定易用性和感知时间投入。

结果

58 只狗被诊断为 IVDE,3 只狗被诊断为缺血性脊髓病。造瘘管置管时的平均神经学分级为 4 级(范围,3 级至 5 级)。从造瘘管置管到出院的中位数天数为 1 天(范围,0 天至 3 天)。可获得 56 只狗的随访数据。从造瘘管置管到拔管的中位数天数为 19 天(范围,3 天至 74 天)。报告了 15 例轻微和 6 例严重的术后并发症,主要是意外拔出(11 例)和造瘘口周围尿液渗漏(6 例)。27 位主人对调查问卷做出了回应,主要报告造瘘管使用方便(22/27),且认为时间投入低或可忽略(20/27)。

临床相关性

造瘘管置管术可促进狗早期出院,并允许在因 IVDE 或缺血性脊髓病导致的上运动神经元性膀胱功能障碍恢复期间在家中进行长期尿液管理。该技术易于主人使用。

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