Koerte vere laktaadi ja C-reaktiivse valgu sisalduse prognostiline väärtus maokeeru korral: juhtude analüüs
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Kuupäev
2023
Kättesaadav alates
08.09.2023
Autorid
Kirss, Liisa
Ajakirja pealkiri
Ajakirja ISSN
Köite pealkiri
Kirjastaja
Eesti Maaülikool
Abstrakt
Maokeerd on tavaliselt suurt kasvu ja tõugu koertel esinev ägedalt kulgev eluohtlik haiguslik
seisnud, mille ainuke ravivõte on kirurgiline sekkumine. Olulist osa mängib kirurgilisel
sekkumisel ka gastropeksia teostamine, mis vähendab maokeeru taasteket kuni 95%. Selles
uurimistöös taheti välja selgitada, kas CRP kontsentratsioon vereseerumis ja laktaadi
kontsentratsioon vereplasmas enne operatsiooni ja peale operatsiooni on seotud loomade
ellujäämisega ning milline on nende analüüside prognostiline väärtus paranemisele ning
elumusele. Antud uuringusse kuulus 10 looma, kes kõik saabusid kliinikusse erakorraliselt
maokeeru kahtluse tõttu. Kõik uuringus osalenud loomad saadeti nii kiiresti kui võimalik
operatsioonile. Verest mõõdeti CRP ja laktaat enne operatsiooni (T0), 4 tundi peale
operatsiooni (T1) ning 24 tundi peale esimeste vereproovide võtmist (T2). Laktaadi langus
post-operatiivselt on väga hea prognostiline näitaja looma paranemise osas ning mao
nekroosi olemasolu prognoosimisel. Selles uuringus suri 3 looma. Mediaanväärtus plasma
laktaadil oli selles uuringus ajal T0 oli 6,05 mmol/l ja ajal T1 4,65 mmol/l. Seerumi CRP
mediaan oli ajal T0 6,54 mg/l ja ajal T1 34,25 mg/l. Kõikidele kasutatud artiklitele toetudes
võib järeldada, et laktaadil on väga head prognostilised väärtused, et prognoosida maokeeru
tagajärjel tekkinud mao nekroosi ning kudede kahjustust, mis omakorda aitab prognoosida
paranemist. CRP väärtus prognostilise markerina maokeeru puhul on küsitava väärtusega
ning oleks kindlasti vaja suuremahulist uuringut, et nimetatud väärtusi koos hinnata ning
jõuda selgusele, kas nende koos hindamine suudab haiguse kulgu, ning ka suremust,
täpsemalt prognoosida.
Gastric dilatation and volvulus (GDV) is an acute and life-threatening medical condition that usually occurs in dogs of large size and breed. The only treatment option is surgical intervention. Performing a gastropexy also plays an important role in surgical intervention, which reduces the reoccurence of gastric volvulus by up to 95%. In this study it was questioned if C- reactive protein (CRP) and lactate concentrations in blood before and after surgery have a prognostic value of recovery and survival. In the study, there were 10 animals, all of which arrived at the clinic as an emergency because of suspected gastric torsion. All animals participating in the study were sent for surgery as soon as possible. CRP and lactate were measured in blood before surgery (T0), 4 hours after surgery (T1) and 24 hours after taking the first blood samples (T2). The decrease in lactate post-operatively is a very good prognostic indicator for the recovery of the animal and for predicting the presence of gastric necrosis. 3 animals died in this study. The median value of plasma lactate in this study was 6.05 mmol/l at the time T0 and 4.65 mmol/l at the time T1. Median serum CRP was 6.54 mg/l at the time T0 and 34.25 mg/l at time T1. Based on all the articles used, it can be concluded that lactate has very good prognostic values to predict gastric necrosis and tissue damage caused by gastric volvulus, which in turn helps to predict recovery. The value of CRP as a prognostic marker for GDV is still questionable, and a large-scale study would definitely be needed to evaluate the mentioned values together to find out whether their combined evaluation can provide a more accurate assessment of the course of the disease and mortality.
Gastric dilatation and volvulus (GDV) is an acute and life-threatening medical condition that usually occurs in dogs of large size and breed. The only treatment option is surgical intervention. Performing a gastropexy also plays an important role in surgical intervention, which reduces the reoccurence of gastric volvulus by up to 95%. In this study it was questioned if C- reactive protein (CRP) and lactate concentrations in blood before and after surgery have a prognostic value of recovery and survival. In the study, there were 10 animals, all of which arrived at the clinic as an emergency because of suspected gastric torsion. All animals participating in the study were sent for surgery as soon as possible. CRP and lactate were measured in blood before surgery (T0), 4 hours after surgery (T1) and 24 hours after taking the first blood samples (T2). The decrease in lactate post-operatively is a very good prognostic indicator for the recovery of the animal and for predicting the presence of gastric necrosis. 3 animals died in this study. The median value of plasma lactate in this study was 6.05 mmol/l at the time T0 and 4.65 mmol/l at the time T1. Median serum CRP was 6.54 mg/l at the time T0 and 34.25 mg/l at time T1. Based on all the articles used, it can be concluded that lactate has very good prognostic values to predict gastric necrosis and tissue damage caused by gastric volvulus, which in turn helps to predict recovery. The value of CRP as a prognostic marker for GDV is still questionable, and a large-scale study would definitely be needed to evaluate the mentioned values together to find out whether their combined evaluation can provide a more accurate assessment of the course of the disease and mortality.
Kirjeldus
Lõputöö
Veterinaarmeditsiini õppekaval
Märksõnad
magistritööd, laktaat, C-reaktiivne valk, mao laienemine ja keerd, koer