在猫的小孔导丝胸腔造口插管置入过程中,为避免插入并发症而建议采用的仰卧姿势--尸体研究。

IF 2.3 2区 农林科学 Q1 VETERINARY SCIENCES BMC Veterinary Research Pub Date : 2024-10-01 DOI:10.1186/s12917-024-04301-7
Desiree Siegelmayer, Eva Schnabl-Feichter, Alexander Tichy, Gabriele Gradner, Brigitte Degasperi, Lea Liehmann
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引用次数: 0

摘要

背景:小孔导丝胸腔造口管(SBWGTT)常用于猫咪胸膜疾病的治疗,并发症发生率通常较低。我们的研究旨在探讨猫的卧姿、置管方法和插入并发症发生率之间的相关性,以确定 SBWGTT 置管时的风险因素。在这项尸体实验研究中,我们在 24 只猫科动物尸体上使用改良的 Seldinger 技术进行了 SBWGTT 置管术。因与研究无关的原因被安乐死的猫被随机分配到胸腔积液组(EFF;n = 12)和气胸组(PNEU;n = 12)。每具尸体均插管通气,吸气峰压 (PIP) 为 10 mmHg,并通过第四肋间隙 (ICS) 的 5 mm 胸腔镜套管将无菌生理盐水或空气灌入胸腔。在有利体位用超声波测量侧胸壁到肺的距离(TWLD)达到 10 至 12 毫米时停止灌注。EFF组的有利体位是胸骨后卧位,PNEU组的有利体位是侧卧位。在各组放置第一个 SBWGTT 后,将尸体置于不利体位(EFF 组为侧卧位,PNEU 组为胸骨后卧位),并在对侧插入第二个引流管。然后进行双侧第 8 次 ICS 开胸手术,以直观评估胸腔内结构和引流管的完整性。采用二元逻辑回归混合模型确定诱导条件与体位之间的交互作用:共放置了 48 个 SBWGTT,33.3%(8/24)的病例出现了并发症。其中五例为肺裂伤等严重并发症。不利体位的并发症更常见,占 75%,但这一结果没有统计学意义。不利体位的并发症几率大于 70%,并随着 TWLD 的增加而降低(结论:SBWTT 相关并发症的发生率与 TWLD 的增加有关):与 SBWGTT 置放相关的并发症受侧卧位的影响,但数据未达到统计学意义。在治疗气胸时将猫置于侧卧位,在治疗胸腔积液时将猫置于胸骨后位可减少插入并发症。
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Recommended recumbency to avoid insertional complications during small-bore wire-guided thoracostomy tube placement in cats-a cadaver study.

Background: Small-bore wire-guided thoracostomy tubes (SBWGTT) are commonly used in cats to manage pleural disease and generally have a low complication rate. Our study aimed to explore the correlation between recumbency of cats, placement method, and the occurrence of insertional complications to identify risk factors during SBWGTT placement. In this experimental cadaveric study, SBWGTT placement using a modified Seldinger technique was conducted in 24 feline cadavers. Cats, euthanized for reasons unrelated to the study, were randomly assigned to pleural effusion (EFF; n = 12) and pneumothorax (PNEU; n = 12) groups. Each cadaver was intubated and ventilated with a peak inspiratory pressure (PIP) of 10 mmHg, and sterile saline or air was instilled into the thorax over a 5 mm thoracoscopic trocar in the fourth intercostal space (ICS). Instillation was stopped when the lateral thoracic wall to lung distance (TWLD) reached 10 to 12 mm, measured with ultrasound in the favorable position. Sternal recumbency was the favorable position for the EFF group, and lateral recumbency for the PNEU group. Following the placement of the first SBWGTT in each group, the cadavers were positioned unfavorably (lateral recumbency for EFF group, sternal recumbency for PNEU group), and a second drain was introduced contralaterally. A bilateral 8th ICS thoracotomy was then performed to visually assess intrathoracic structures and drain integrity. A binary logistic regression mixed model was conducted to determine interaction between the induced condition and body position.

Results: A total of 48 SBWGTTs were placed, with complications observed in 33.3% (8/24) of cases. Five of these were major complications consisting of lung lacerations. Complications were more common in the unfavorable position, accounting for 75% of cases, although this result was not statistically significant. The odds of complication rates were > 70% in the unfavorable position and decreased with an increase in TWLD (< 30%).

Conclusion: Complications associated with SBWGTT placement are influenced by recumbency, although the data did not reach statistical significance. Placing cats in lateral recumbency for pneumothorax treatment and sternal recumbency for pleural effusion treatment may reduce insertional complications.

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来源期刊
BMC Veterinary Research
BMC Veterinary Research VETERINARY SCIENCES-
CiteScore
4.80
自引率
3.80%
发文量
420
审稿时长
3-6 weeks
期刊介绍: BMC Veterinary Research is an open access, peer-reviewed journal that considers articles on all aspects of veterinary science and medicine, including the epidemiology, diagnosis, prevention and treatment of medical conditions of domestic, companion, farm and wild animals, as well as the biomedical processes that underlie their health.
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