Svendsen C K, Hjortkjaer R K, Hesselholt M
Nord Vet Med. 1979 Oct;31(10):Suppl 1-32.
42 horses were examined. The physical signs with relation to circulatory insufficiency and the abdominal disease were registered following a two-phased examination procedure. Great prognostic value was found in the degree of circulatory insufficiency judged by pulse rate and character, filling of the jugular vein, skin temperature, colour of mucous membranes, capillary refill time, sweating, depression, skin turgor and degree of enophthalmus. In making a causal diagnosis the abdomen was examined for shape, tenderness, peristaltic sounds, gastric dilation by siphoning, abnormal rectal findings and macroscopic changes in peritoneal fluid. Greatest diagnostic difficulties were encountered in cases of intestinal atonia, acute enteritis and torsion of the colon. In selected (severe) cases laboratory tests were obtained. Blood samples were examined for packed cell volume, hemoglobin, red and white blood cell counts, differential white blood cell count, blood gases and acid-base status, lactate, serum total protein and albumin, plasma sodium, potassium, chloride, calcium, magnesium, inorganic phosphorus, glucose, creatinine, BUN, total bilirubin, ASAT, CK, BASP and GGT. Peritoneal fluid was examined for red blood and white cell counts, total protein, specific gravity, pH and lactate, and enzymes as in blood. Laboratory results generally confirmed the clinical signs of shock, and packed cell volume and blood lactate were regarded to be of greatest prognostic interest. Although the performed laboratory information, macroscopic evaluation was thought to reveal sufficient information in most cases. It was concluded that supervening shock is of decisive importance in severe forms of colic, and that a careful and repeated evaluation of the circulatory insufficiency often provides one with a tentative prognosis although the final diagnosis is not obtained. In spite of therapy fatal outcome was found in all seriously shocked horses.
对42匹马进行了检查。按照两阶段检查程序记录与循环功能不全和腹部疾病相关的体征。通过脉搏率和特征、颈静脉充盈情况、皮肤温度、黏膜颜色、毛细血管再充盈时间、出汗情况、精神沉郁、皮肤弹性和眼球凹陷程度判断循环功能不全的程度,发现其具有很大的预后价值。在进行病因诊断时,检查腹部的形状、压痛、肠蠕动音、通过虹吸法检查胃扩张情况、直肠异常发现以及腹腔积液的宏观变化。在肠弛缓、急性肠炎和结肠扭转病例中遇到的诊断困难最大。在选定的(严重)病例中进行了实验室检查。检测血样的血细胞压积、血红蛋白、红细胞和白细胞计数、白细胞分类计数、血气和酸碱状态、乳酸、血清总蛋白和白蛋白、血浆钠、钾、氯、钙、镁、无机磷、葡萄糖、肌酐、血尿素氮、总胆红素、谷草转氨酶、肌酸激酶、碱性磷酸酶和γ-谷氨酰转肽酶。检测腹腔积液的红细胞和白细胞计数、总蛋白、比重、pH值和乳酸以及与血液中相同的酶。实验室结果通常证实了休克的临床体征,血细胞压积和血乳酸被认为具有最大的预后意义。尽管进行了实验室检查,但在大多数情况下,宏观评估被认为能提供足够的信息。得出的结论是,继发性休克在严重的绞痛形式中具有决定性意义,尽管最终诊断未明确,但对循环功能不全进行仔细且反复的评估通常能提供一个初步的预后判断。尽管进行了治疗,但所有严重休克的马匹均出现了死亡结局。