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手术治疗胃扩张-扭转的犬围手术期死亡率相关因素:137例病例(1988 - 1993年)

Factors associated with perioperative mortality in dogs with surgically managed gastric dilatation-volvulus: 137 cases (1988-1993).

作者信息

Brourman J D, Schertel E R, Allen D A, Birchard S J, DeHoff W D

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus 43210, USA.

出版信息

J Am Vet Med Assoc. 1996 Jun 1;208(11):1855-8.

PMID:8675474
Abstract

OBJECTIVE

To evaluate factors associated with perioperative mortality in dogs with gastric dilatation-volvulus and to determine the influence of treatment differences between university and private specialty practices on outcome.

DESIGN

Retrospective analysis of medical records.

ANIMALS

137 dogs with gastric dilatation-volvulus.

PROCEDURE

Signalment; frequency of preoperative and postoperative treatments and complications; intraoperative findings; surgical technique; and hematologic, serum biochemical, and electrocardiographic results were recorded, evaluated for association with mortality, and compared between institutions.

RESULTS

Mortality did not differ between institutions, and overall mortality was 18% (24/137). Surgical techniques differed between institutions, but were not associated with mortality. Gastric necrosis was associated with significantly higher mortality (46%; 13/28). When partial gastrectomy or splenectomy was performed, mortality (35 and 32% or 8/23 and 10/31, respectively) was significantly increased. Splenectomy was performed in 11 of 23 dogs requiring partial gastrectomy, and when both procedures were performed, mortality (55%; 6/11) was significantly increased. Preoperative cardiac arrhythmias were associated with significantly higher mortality (38%; 6/16). Mortality in dogs > 10 years old was not significantly greater than that in younger dogs.

CLINICAL IMPLICATIONS

Patient management differences between practices did not seem to influence survival in dogs with surgically managed gastric dilatation-volvulus. Signalment, including age, did not influence mortality. Gastric necrosis, gastric resection, splenectomy, and preoperative cardiac arrhythmias were associated with mortality > 30%.

摘要

目的

评估胃扩张-扭转患犬围手术期死亡的相关因素,并确定大学专科诊疗机构与私立专科诊疗机构之间治疗差异对预后的影响。

设计

病历回顾性分析。

动物

137只胃扩张-扭转患犬。

方法

记录品种特征、术前和术后治疗及并发症的发生频率、术中所见、手术技术以及血液学、血清生化和心电图检查结果,评估其与死亡率的相关性,并在不同机构之间进行比较。

结果

不同机构之间的死亡率无差异,总体死亡率为18%(24/137)。不同机构之间的手术技术存在差异,但与死亡率无关。胃坏死与显著更高的死亡率相关(46%;13/28)。当进行部分胃切除术或脾切除术时,死亡率显著增加(分别为35%和32%,即8/23和10/31)。在23只需要进行部分胃切除术的犬中,有11只进行了脾切除术,当两种手术都进行时,死亡率显著增加(55%;6/11)。术前心律失常与显著更高的死亡率相关(38%;6/16)。10岁以上犬的死亡率并不显著高于年轻犬。

临床意义

不同诊疗机构之间的患者管理差异似乎并未影响接受手术治疗的胃扩张-扭转患犬的生存。包括年龄在内的品种特征并未影响死亡率。胃坏死、胃切除术、脾切除术和术前心律失常与死亡率>30%相关。

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