【摘要】：犬子宮蓄膿是寵物臨床常見產(chǎn)科疾病之一。本文從22例罹患子宮蓄膿病犬的營(yíng)養(yǎng)狀況、流行病學(xué)、血液學(xué)、影像學(xué)、組織病理、宮內(nèi)微生物培養(yǎng)、藥敏試驗(yàn)及治療等方面開展研究,旨在為子宮蓄膿臨床綜合診療提供借鑒和依據(jù)。試驗(yàn)顯示6歲以上無(wú)生育史的母犬是子宮蓄膿癥的易發(fā)群體。品種、免疫狀況及營(yíng)養(yǎng)狀況從數(shù)據(jù)上顯示與該病無(wú)相關(guān)性�；既R床常表現(xiàn)為精神沉郁,煩渴多尿、嘔吐腹瀉、腹圍膨大、陰門紅腫、陰道有異臭味分泌物排出、體溫升高或下降、可視粘膜蒼白等癥狀。血液學(xué)檢測(cè)結(jié)果顯示:患犬一般出現(xiàn)白細(xì)胞增多癥,最高可達(dá)正常值3倍以上;中性粒細(xì)胞增多,幼稚型白細(xì)胞增加,可達(dá)80%以上;病程較長(zhǎng)的患犬發(fā)生貧血;發(fā)展為敗血癥患犬則白細(xì)胞減少;亦有少數(shù)患犬血象正常。多數(shù)患犬會(huì)出現(xiàn)不同程度的腎臟和肝臟功能異常,常見血液尿素氮(BUN)增加,達(dá)12mmol/l以上;乳酸脫氫酶(LDH)大于328iu/l;谷草轉(zhuǎn)氨酶(AST)大于41iu/l;總膽紅素6倍與正常值;提示患犬一定程度的肝腎功能障礙。B超檢查通�？捎^察到蓄膿子宮的形態(tài)、大小和位置;病理性子宮蓄膿B超影像多為長(zhǎng)條狀無(wú)回聲均勻暗液區(qū)�；既∽儏^(qū)組織病理切片顯示,大多數(shù)病變部位無(wú)腫瘤生長(zhǎng)的跡象。卵巢多見持久黃體或多囊卵泡,部分患犬可見卵巢部有粒層細(xì)胞瘤或乳頭狀腺瘤。閉鎖型患犬常見子宮壁變薄、子宮內(nèi)膜萎縮或潰瘍;開放型患犬多表現(xiàn)為囊性子宮內(nèi)膜增生及子宮內(nèi)膜炎;提示閉鎖型較開放型子宮蓄膿嚴(yán)重。從22例患犬中,全部分離到細(xì)菌,不排除有些為子宮內(nèi)常態(tài)菌。主要分離到的致病菌為大腸桿菌(77.27%)和β-溶血鏈球菌(13.64%),其余的是葡萄球菌及芽孢菌。說(shuō)明大腸桿菌是引起子宮蓄膿的主要致病菌,其對(duì)卡那霉素和新霉素的敏感率最高,均達(dá)到了100%。根據(jù)臨床癥狀、血液學(xué)檢查、影像學(xué)檢查及細(xì)菌分離藥敏試驗(yàn)的結(jié)果對(duì)患犬采用不同的治療方法,22例患犬全部治愈。其中對(duì)6例患犬采取保守療法,占治愈總數(shù)的27.27%;有16例采取手術(shù)療法,占治愈總數(shù)的72.73%。迄今為止,卵巢子宮全摘除術(shù)仍是治療子宮蓄膿的首選方法。對(duì)于有重要育種價(jià)值或其他原因無(wú)法進(jìn)行手術(shù)的患犬,可考慮施行子宮沖洗,并結(jié)合宮內(nèi)細(xì)菌藥敏試驗(yàn)采取針對(duì)性強(qiáng)的抗菌消炎等保守治療。
[Abstract]:Pus storage in dogs is one of the common obstetrical diseases in pet clinic. The nutritional status, epidemiology, hematology, imaging, histopathology, intrauterine microorganism culture, drug sensitivity test and treatment of 22 dogs with sepsis were studied. In order to provide reference and basis for clinical comprehensive diagnosis and treatment of uterine pus storage. The study showed that infertile dogs over 6 years of age were susceptible to sepsis. Variety, immune status and nutritional status were not correlated with the disease. The clinical manifestations of the dogs are depression, thirst, vomiting, diarrhea, abdominal enlargement, redness of the vulva, vaginal discharge of odorous secretions, elevated or decreased body temperature, paleness of the visible mucosa, and so on. The results of hematological examination showed that leukopenia appeared in dogs, the highest value was above 3 times of normal value, neutrophilic granulocyte and infantile leukocyte were increased to more than 80%, anemia was found in dogs with long course of disease. There is leukopenia in dogs with septicemia and normal hemogram in a few dogs. Most of the dogs had different degrees of renal and liver dysfunction, the common blood urea nitrogen (BUN) increased to more than 12mmol/l, the lactate dehydrogenase (LDH) was more than 328iu / l, the glutamic oxaloacetic transaminase (AST) was more than 41 IU / l. The total bilirubin was 6 times as high as the normal value, indicating that there was a certain degree of liver and kidney dysfunction in the affected dogs. The shape, size and location of the suppurative uterus were usually observed by B-ultrasonography. Histopathological sections of the diseased canine showed that most lesions showed no signs of tumor growth. Persistent corpus luteum or polycystic follicles were found in ovary and granulocytoma or papillary adenoma were found in some dogs. The common uterine wall thinning, endometrial atrophy or ulceration in atresia type dogs, and cystic endometrial hyperplasia and endometritis were more common in open type dogs, which suggested that atresia type was more serious than open type uterine pus storage type. Bacteria were isolated from 22 dogs, some of which were normal bacteria in the uterus. The main pathogenic bacteria were Escherichia coli (77.27%) and 尾 -hemolytic streptococcus (13.64%), the rest were Staphylococcus and Bacillus. The results showed that Escherichia coli was the main pathogen causing uterine pus, and its sensitivity to kanamycin and neomycin was the highest, reaching 100%. According to the results of clinical symptoms, hematological examination, imaging examination and bacterial isolation drug sensitivity test, 22 dogs were cured with different treatment methods. Among them, 6 dogs were treated with conservative therapy, accounting for 27.27% of the total number of cured dogs, and 16 cases were treated with surgical therapy, accounting for 72.73% of the total number of cured dogs. Up to now, total ovariectomy is still the first choice for the treatment of suppuration. For dogs with important breeding value or other reasons which can not be operated on, we can consider the use of uterine washing, combined with intrauterine bacterial drug sensitivity test to take targeted conservative treatment, such as antibacterial and anti-inflammatory.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：S858.292

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