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2002-2020 年采用美拉德缩窄环缩窄术治疗的 20 例先天性肝外门体分流猫的临床疗效。

Clinical outcomes for 20 cats with congenital extrahepatic portosystemic shunts treated with ameroid constrictor ring attenuation (2002-2020).

机构信息

University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA.

出版信息

Vet Surg. 2024 Feb;53(2):243-253. doi: 10.1111/vsu.14066. Epub 2023 Dec 28.

Abstract

OBJECTIVE

To report the clinical perioperative, short-term, and long-term outcomes for cats undergoing ameroid ring constrictor (ARC) attenuation of a congenital extrahepatic portosystemic shunt (EHPSS).

STUDY DESIGN

Retrospective case series from a single veterinary teaching hospital (2002-2020).

ANIMALS

Twenty client-owned cats with EHPSS.

METHODS

Data collected from medical records included signalment, history, physical examination, clinicopathologic testing, medications, diagnostic imaging, intraoperative findings, perioperative complications, and postoperative clinical outcomes. Long-term clinical outcome was obtained from a standardized owner interview or medical records.

RESULTS

Perioperative complications were reported in five cats out of 20, including blindness (two cats), ascites (one cat), head pressing (one cat), and seizures and death (one cat). Short-term clinical outcome was excellent in 14/18 cats, good in 2/18 cats, and poor in 2/18 cats that were available for follow up, and long term clinical outcome was excellent in 15/18, good in 1/18 cats, and poor in 2/18 cats that were available for follow up.

CONCLUSION

Long-term clinical outcome was good or excellent in 16/18 of cats available for follow up. Perioperative complications were reported in five cats.

CLINICAL SIGNIFICANCE

Surgical attenuation of EHPSS with an ARC can result in resolution of clinical signs and biochemical abnormalities in the majority of cats. The perioperative complication rate for feline patients with EHPSS attenuated with an ARC was lower than reported historically. Seizures may persist in the long term despite normal bile acid stimulation test results, complete blood count, and biochemistry analysis.

摘要

目的

报告 20 例猫施行 Ameroid 环缩术(ARC)减弱先天性肝外门体分流(EHPSS)的临床围手术期、短期和长期结果。

研究设计

单兽医教学医院(2002-2020 年)的回顾性病例系列。

动物

20 只患有 EHPSS 的患宠猫。

方法

从病历中收集的数据包括一般信息、病史、体格检查、临床病理检查、药物、诊断影像学、术中发现、围手术期并发症以及术后临床结果。通过标准化的主人访谈或病历获得长期临床结果。

结果

20 例中有 5 例(25%)出现围手术期并发症,包括失明(2 例)、腹水(1 例)、头部压迫感(1 例)、癫痫发作和死亡(1 例)。18 例中短期临床结果优良者 14 例(78%),一般者 2 例(11%),可随访者中不良者 2 例(11%)。18 例中可随访者长期临床结果优良者 15 例(83%),一般者 1 例(6%),不良者 2 例(11%)。

结论

18 例可随访者中,16 例(89%)的长期临床结果良好或优秀。5 例出现围手术期并发症。

临床意义

ARC 减弱 EHPSS 可使大多数猫的临床症状和生化异常得到缓解。施行 ARC 减弱 EHPSS 的猫的围手术期并发症发生率低于既往报道。尽管胆汁酸刺激试验、全血细胞计数和生化分析正常,癫痫可能仍会长期存在。

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