对因小肠病变而接受探查性开腹手术的马匹术中单次剂量地塞米松效果的回顾性评估（2008-2019年）：240例。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care Pub Date : 2024-05-29 DOI:10.1111/vec.13374

Rose E. Tallon MA, VetMB, MVetMed, DACVIM, Sarah E. Allen BVetMed, MSc PhD, Bruce M. Bladon BVM&S, DESTS, DECVS, Kate F. McGovern BVetMed, MS DACVIM, DECEIM

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引用次数: 0

摘要

目的确定术中单次使用地塞米松对接受小肠手术的马匹术后反流（POR）风险的影响，并研究其与切口并发症和短期存活率的关系：设计：11 年间（2008-2019 年）的回顾性队列研究：地点：英国私立转诊中心：240匹年龄大于6个月的客户饲养的马匹接受探查性开腹手术，以治疗小肠病变：97匹马在术中接受了单剂量地塞米松（0.1毫克/千克，静脉注射）：在接受地塞米松治疗的97匹马中，52匹（53.6%）需要进行小肠切除术。在 143 匹未接受地塞米松治疗的马中，78 匹（54.5%）需要进行小肠切除术。共有70匹马（29%）发生了POR。接受地塞米松治疗的马匹（25/97；26%）和未接受地塞米松治疗的马匹（45/143；31%，P = 0.34）发生POR的风险没有差异。与发生 POR 相关的风险因素包括小肠切除术（几率比 [OR]：4.55，95% 置信区间[CI]：2.27-9.11，P 40% 术后 24 小时（OR：4.11，95% CI：2-8.45，P 10 × 109/L 入院时（OR：3.29，95% CI：1.47-7.41，P = 0.004）。地塞米松与 POR 的几率无关。再次接受开腹手术的马发生切口感染的风险较高（OR：8.07，95% CI：1.98-32.81，P = 0.004）。地塞米松的使用与切口感染无关。POR的发生与短期存活率呈负相关（OR：0.07，95% CI：0.03-0.17，P≤0.001）。地塞米松未被纳入最终的生存率多变量模型：结论：在这项研究中，术中使用地塞米松与POR的发生无关，对接受小肠疾病手术治疗的马匹的术后存活率或切口感染也没有影响。

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Retrospective evaluation of the effects of a single intraoperative dose of dexamethasone in horses undergoing exploratory laparotomy for small intestinal lesions (2008–2019): 240 cases

Objective

To determine the effect of a single intraoperative dose of dexamethasone on the risk of postoperative reflux (POR) in horses undergoing small intestinal surgery and to investigate its association with incisional complications and short-term survival.

Design

Retrospective cohort study over an 11-year period (2008–2019).

Setting

UK-based private referral center.

Animals

Two hundred and forty client-owned horses >6 months of age undergoing exploratory laparotomy for treatment of a small intestinal lesion.

Interventions

Ninety-seven horses received a single intraoperative dose of dexamethasone (0.1 mg/kg, IV).

Measurements and Main Results

Of 97 horses that received dexamethasone, 52 (53.6%) required small intestinal resection. Of 143 horses that did not receive dexamethasone, small intestinal resection was performed in 78 (54.5%). A total of 70 horses (29%) developed POR. There was no difference in the risk of POR between horses that received dexamethasone (25/97; 26%) and those that did not (45/143; 31%, P = 0.34). Risk factors associated with the development of POR included small intestinal resection (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 2.27–9.11, P < 0.001), a PCV >40% 24 hours postoperatively (OR: 4.11, 95% CI: 2–8.45, P < 0.001), and a WBC count >10 × 10⁹/L on admission (OR: 3.29, 95% CI: 1.47–7.41, P = 0.004). Dexamethasone was not associated with the odds of POR. Horses undergoing repeat laparotomy had a higher risk of incisional infection (OR: 8.07, 95% CI: 1.98–32.81, P = 0.004). Dexamethasone administration was not associated with incisional infection. The development of POR was negatively associated with short-term survival (OR: 0.07, 95% CI: 0.03–0.17, P ≤ 0.001). Dexamethasone administration was not retained in the final multivariable model for survival.

Conclusions

Intraoperative dexamethasone was not associated with the development of POR in this study population, nor did it have an effect on postoperative survival or incisional infection in horses undergoing surgical management of small intestinal disease.

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来源期刊

Journal of veterinary emergency and critical care 农林科学-兽医学

CiteScore

2.50

自引率

15.40%

发文量

121

审稿时长

18-36 weeks

期刊介绍： The Journal of Veterinary Emergency and Critical Care’s primary aim is to advance the international clinical standard of care for emergency/critical care patients of all species. The journal’s content is relevant to specialist and non-specialist veterinarians practicing emergency/critical care medicine. The journal achieves it aims by publishing descriptions of unique presentation or management; retrospective and prospective evaluations of prognosis, novel diagnosis, or therapy; translational basic science studies with clinical relevance; in depth reviews of pertinent topics; topical news and letters; and regular themed issues. The journal is the official publication of the Veterinary Emergency and Critical Care Society, the American College of Veterinary Emergency and Critical Care, the European Veterinary Emergency and Critical Care Society, and the European College of Veterinary Emergency and Critical Care. It is a bimonthly publication with international impact and adheres to currently accepted ethical standards.