Phillips T J, Walmsley J P
Equine Veterinary Hospital, Liphook, Hampshire, UK.
Equine Vet J. 1993 Sep;25(5):427-31. doi: 10.1111/j.2042-3306.1993.tb02985.x.
Of 149 horses that underwent 151 exploratory laparotomies for gastrointestinal disorders from September 1987 to May 1991, 107 (72%) were discharged from the hospital: 100 (66%) survived for > 7 months, 94 of which returned to their intended use. Survival rate (64/80) for horses with caecum/large colon obstruction was significantly (P = 0.003) higher than for horses with small intestinal obstruction (33/64). Prolonged surgery was associated with significantly (P < 0.001) lower survival rates than short surgical time. In the large intestine, survival rate (15/29) for strangulated obstructions was significantly (P < 0.001) lower than for simple obstructions (52/58). Generalised septic peritonitis (9 horses) and bowel obstruction associated with adhesions (8 horses) were the most frequent fatal post-operative complications. The rate (6/44) of post-operative adhesions after small intestinal obstruction was significantly (P = 0.006) higher than that (2/68) following large intestinal obstruction. The rate (8/55) of post-operative adhesion formation in horses that required enterotomy/enterectomy was significantly (P = 0.003) higher than that (0/57) in horses that did not require gut wall incisions. Incisional suppuration developed in 42 horses and occurred with a significantly (P = 0.028) higher rate (32/72) after caecum/large colon lesions than after obstruction at other sites, (10/42) but was not associated with known contamination at the time of surgery (P = 0.806).
1987年9月至1991年5月,149匹马因胃肠道疾病接受了151次剖腹探查术,其中107匹(72%)出院:100匹(66%)存活超过7个月,其中94匹恢复了预期用途。盲肠/大结肠梗阻马匹的存活率(64/80)显著高于小肠梗阻马匹(33/64)(P = 0.003)。手术时间延长与存活率显著降低相关(P < 0.001)。在大肠中,绞窄性梗阻的存活率(15/29)显著低于单纯性梗阻(52/58)(P < 0.001)。全身性化脓性腹膜炎(9匹马)和粘连性肠梗阻(8匹马)是最常见的术后致命并发症。小肠梗阻后术后粘连发生率(6/44)显著高于大肠梗阻后(2/68)(P = 0.006)。需要肠切开术/肠切除术的马匹术后粘连形成率(8/55)显著高于不需要肠壁切开的马匹(0/57)(P = 0.003)。42匹马发生切口化脓,盲肠/大结肠病变后发生率(32/72)显著高于其他部位梗阻后(10/42)(P = 0.028),但与手术时已知的污染无关(P = 0.806)。