Haven M L, Bowman K F, Engelbert T A, Blikslager A T
Department of Food Animal and Equine Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh 27606.
Cornell Vet. 1993 Jan;83(1):47-55.
Twenty-one cases of urolithiasis in small ruminants were examined to evaluate the efficacy of various surgical treatments. Of 21 cases, all but 1 had multiple calculi. Urethral process amputation and medical therapy either did not relieve the obstruction or provided only temporary relief (< 36 hours) in 14 of 16 cases. In 2 cases, obstruction recurred in 1 year and 4 years, respectively, after urethral process amputation. Ten of 13 animals that had perineal urethrostomy (PU) experienced short-term complications, including postoperative hemorrhage, dehiscence of the surgical wound, and subcutaneous accumulation of urine. Urethral stricture occurred in 7 of 9 animals in which follow-up information was obtained, and long-term survival was 55%. Cystotomy alone was performed on 8 of 21 cases, and 7 of 8 (88%) were healthy at the time of follow-up. In order to relieve the obstruction with cystotomy alone, multiple attempts at normograde and retrograde flushing were required. Cystotomy allowed removal of multiple calculi, bidirectional flushing of the urethra, and posed less risk for short-term postoperative complications and urethral stricture. These data suggest that cystotomy was more effective than PU for the management of urolithiasis in small ruminants.
对21例小反刍动物尿石症病例进行了检查，以评估各种手术治疗方法的疗效。在这21例病例中，除1例之外均有多发结石。尿道突切除术和药物治疗在16例中的14例中，要么无法缓解梗阻，要么仅提供了短暂缓解（<36小时）。在2例中，尿道突切除术后分别在1年和4年出现梗阻复发。接受会阴尿道造口术（PU）的13只动物中有10只出现短期并发症，包括术后出血、手术伤口裂开和皮下尿液积聚。在9只获得随访信息的动物中，有7只出现尿道狭窄，长期存活率为55%。21例中有8例仅进行了膀胱切开术，随访时8例中有7例（88%）健康。为了仅通过膀胱切开术缓解梗阻，需要多次进行顺行和逆行冲洗尝试。膀胱切开术可以取出多发结石、对尿道进行双向冲洗，并且术后短期并发症和尿道狭窄的风险较小。这些数据表明，对于小反刍动物尿石症的治疗，膀胱切开术比会阴尿道造口术更有效。
