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犬猫尿道破裂的成功保守治疗:52例(2003 - 2024年)

Successful conservative management of urinary tract rupture in dogs and cats: 52 cases (2003-2024).

作者信息

Toh C S L, Rossanese M, Cook S D

机构信息

Royal Veterinary College, University of London, Hatfield, UK.

出版信息

J Small Anim Pract. 2025 Oct;66(10):732-738. doi: 10.1111/jsap.13882. Epub 2025 Jun 1.

Abstract

OBJECTIVES

To describe the successful conservative management of urinary tract ruptures in dogs and cats.

MATERIALS AND METHODS

Medical records of a hospital between 2003 and 2024 were reviewed to identify dogs and cats with urinary tract rupture. Cases were included if they were successfully managed conservatively (including only procedures that did not directly address the site of rupture). Data recorded included signalment, cause and location of rupture, method and duration of urinary diversion, outcome and complications.

RESULTS

Fifty-two cases (40 cats and 12 dogs) were included. The most common causes of rupture were trauma associated with urethral obstruction and catheterisation (18), cystocentesis (17) and external trauma (8). The most common sites of rupture were the urethra (20 cats and five dogs) and urinary bladder (15 cats and four dogs). Bladder ruptures were most commonly managed with urethral catheters and/or peritoneal drains, while urethral ruptures were most commonly managed with urethral catheters and/or cystostomy tubes. The median (range) time to resolution of urine leakage documented on imaging was 3 (1 to 6) days for bladder ruptures and 6.5 (3 to 28) days for urethral ruptures. Radiographic evidence of urethral narrowing was documented in 11/25 cases with urethral tears at a median (range) of 12 (4 to 28) days post-rupture. Urine culture was performed in 22/52 cases with urinary tract ruptures and was positive in 14 cases.

CLINICAL SIGNIFICANCE

Conservative management can be considered in both iatrogenic and traumatic urinary tract ruptures. The risk of urethral strictures and urinary tract infections should be considered when electing for conservative management of urinary tract ruptures.

摘要

目的

描述犬猫尿路破裂的成功保守治疗方法。

材料与方法

回顾某医院2003年至2024年的病历,以确定患有尿路破裂的犬猫。如果病例通过保守治疗成功(仅包括未直接处理破裂部位的操作),则纳入研究。记录的数据包括动物特征、破裂原因和位置、尿液改道方法和持续时间、治疗结果及并发症。

结果

共纳入52例病例(40只猫和12只犬)。破裂的最常见原因是与尿道梗阻和导尿相关的创伤(18例)、膀胱穿刺(17例)和外部创伤(8例)。最常见的破裂部位是尿道(20只猫和5只犬)和膀胱(15只猫和4只犬)。膀胱破裂最常采用尿道导管和/或腹腔引流管进行处理,而尿道破裂最常采用尿道导管和/或膀胱造瘘管进行处理。影像学记录显示膀胱破裂尿液漏出消失的中位(范围)时间为3(1至6)天,尿道破裂为6.5(3至28)天。25例尿道撕裂病例中有11例记录到尿道狭窄的影像学证据,中位(范围)时间为破裂后12(4至28)天。52例尿路破裂病例中有22例进行了尿培养,14例呈阳性。

临床意义

医源性和外伤性尿路破裂均可考虑采用保守治疗。选择尿路破裂的保守治疗时,应考虑尿道狭窄和尿路感染的风险。

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