给陆龟取结石

首席村妇

转贴于国外某宠物医院，感谢小六子和兮若的翻译。

    诊断

    There are two methods utilized to diagnose bladder stones. During an examination we can sometimes palpate a stone by gently rolling the tortoise back and forth while we feel in the soft spot by its rear leg. To perform the palpation technique you need to understand tortoise anatomy and be experienced at palpation.

    有两种方法可以去诊断结石， 有的时候在检查中可以触诊到石头，我们可以轻轻的前后滚动着龟，同一时间 可以感觉到他后腿的一处软软的地方，使用这种方法，你须懂得陆龟解刨学，或是一个诊断专家。

Not every stone can be found on palpation. The other method to make a diagnosis, and usually more reliable method, is to take an x-ray. Even though the stone in this x-ray is large, this is not an unusual finding. Some of the stones are so large that we have to break them into pieces to get them out of the opening in the shell.

    不是每个石头都可以在初步诊断里发现。 另一种诊断的办法，一般来说是更可靠的。 那就是用x光。不论石头的有多大，都不会找不到的， 有些大到一定程度的石头 需要我们去把它弄成小块后，才可以从壳里取出来。

Surgical Procedure

    手术步骤

    The usual treatment for a bladder stone in tortoises is to perform surgery. In this surgery we literally cut a hole in the bottom of the shell and remove the stone from the bladder. Most tortoises do fine postoperatively, and after a few days in the hospital and a few weeks of recuperation at home, they are back to normal.
    The following area contains graphic pictures of an actual surgical procedure performed at the hospital. It may not be suitable for some children (and some adults also!).
    Prior to surgery our patient is prepared to minimize anesthetic risk. In some patients we place a feeding tube to insure adequate hydration and nutrition, both before and after the surgery. In other patients we insert an intravenous catheter (IV) to maintain blood pressure during surgery.
    This tortoise has an IV catheter in its jugulare vein. We use this vein because it is relatively easy to insert the catheter and it is large enough to take the volume of fluid we need to give.

    通常解决陆龟结石问题是要手术的，在手术时，学术上是可以在靠后一点的壳上切一个小洞，然后取出结石。一般手术后，不会太影响陆龟，在兽医院过个几天后，或者几周的疗养休息，就可以回家康复了，跟以前一样。

    以下的内容（包括了详细的手术程序图）来自一家兽医院。可能会让儿童（或者有些大人）感到不适。

    在手术前，先要减少麻醉的危机，有些患者 我们会放一个喂养管去给予足够的营养与水分， 在手术前与手术后都需要去完成。

    对于其他的患者我们会插入一个静脉内的导管去控制手术时的血压。

    陆龟在它的颈静脉需有一只导管。这样的话，我们就可以轻松的给它输入该提供的液量。

After the tortoise is anesthetized the bottom of the shell (called the plastron) is cleansed thoroughly. This may take several scrubbings with the use of a gentle brush to get clean enough for surgery. The black rectangle outlines where the shell will eventually be cut to gain access to the bladder.

    当乌龟被麻醉后，他的胸甲要被彻底清洗干净。需要拿一个柔软的刷子多刷几下，让他足够干净，然后要沿着壳上的方形线条切。

As in any surgery we perform controlling infection is critical. We use a specific draping technique to minimize the chance of infection. Infection is especially critical in this surgery because once the cut piece of shell is resealed to the bottom of the shell, an infection can fester on the inside without our knowing about it.

    任何手术都要防止感染，我们用一个特殊技术来最小化感染的机会。切掉一部分龟壳再重新盖上去的话可能会引起里面的灌胧。

The rest of the surgical team is preparing at the same time. These assistants are students in our externship program. They will be assisting the surgeon with flushing and suctioning of fluids, along with the administration of anesthesia.

    剩下的外科手术成员这个时候需要准备，这些助手都是学生。他们会协助医生冲洗，吸走液体以及麻醉。

Dr. Ridgeway starts his cut with his safety glasses on to protect him from particles brought on by the drill used to cut into the shell.

    当使用钻子的时候，医生戴上安全眼睛来保护他的眼睛。

A sterilized dremel is used to cut through the shell. The blade spins at a high speed so sterile water needs to be constantly applied to the cut surface to minimize burning. The blade cuts at an angle facilitating replacement of the shell when the surgery is complete. If this angled cut is not made, the shell will just fall back into the abdominal cavity (it is called the coelomic cavity in a reptile) and the incision site will never heal.

    一个无菌的XX（大概是带刀片的钻子一类的东西）用来切龟壳。因为钻子速度很快，所以要在切割面不停地使用无菌水以减少火花。切割的时候需要斜着一个角度切，不然的话壳会掉入一个腰部的洞（？？？实在不懂），而且切的地方以后也不能恢复。

When the shell has been cut in a rectangular piece it is gently pried up with an instrument called an elevator. There are muscular attachments that are gently separated from the shell to allow the shell to become completely free. The cut shell is living tissue and needs careful handling. After it is removed it is kept moist with sterile saline until it is replaced at the end of the surgery.

    当一个长方形的龟壳被切下来后，需要用一个工具轻轻的把龟壳挑起来，让龟壳和肉分离。切下来的龟壳还是活组织，所以要小心对应，应该放置在潮湿和有消毒盐水的环境里里等手术完了在放回去。

The next layer encountered is the lining of the coelomic cavity. It is gently cut to give full exposure to the organs in the cavity. The reddish areas are the muscular attachments to the piece of shell that was removed.

    接下来要做的就是要剪开龟壳下面的内膜进入体腔。

Internal organs can be visualized easily through this large opening. These are loops of intestines.

    内膜揭开后，这个内膜组织就完全呈现了，会看到一圈一圈的肠子。

The bladder is gently exteriorized through the hole in the shell. Dr. Ridgeway has made an incision into the bladder and the stone is starting to bulge out.

    把膀胱轻轻的通过这个洞取出来，医生切割了膀胱，发现结石已经膨胀了。

Here is the culprit as it is being removed from the bladder.

    这是已经去除了结石的膀胱。

The bladder is usually filled with a sludge like material. If the sludge is not removed healing will be delayed and the potential for recurrence of the stone increases. The larger clumps of sludge are removed with a special instrument called an angle spoon. This high tech instrument is made special in our lab by taking a regular tablespoon and bending it.

    膀胱一般都是充满了淤血在里面的，如果不把这些淤血去处了会导致重新产生结石。大块的淤血用一种特殊的器材来清除。这个特殊的器材是用一个大汤匙再弄弯了做的。

The smaller pieces are suctioned after the bladder has been flushed. This usually takes many flushings with sterile saline. Only when the bladder has been thoroughly flushed is it sutured back together.

    膀胱被消毒盐水冲洗以后会变的小一些。只有在被彻底冲洗后才能放回去。


A special suture material is used to close the opening in the bladder. This suture is very strong yet causes minimal tissue reaction, and will slowly dissolve over several months.

    一种特殊的材料用来缝合膀胱上的伤口。这种材料非常坚固让生理的反应最小，而且会在几个月后慢慢溶解。


The coelomic cavity is also flushed copiously with warm sterile saline, then the fluid is suctioned out. This process helps prevent an infection and aids in the healing process. If an infection is sealed into the coelomic cavity the outcome could be catastrophic.

    体腔也需要用大量的消毒盐水来清洗，在把液体吸出来。这个过程用于防止感染和帮助恢复。如果在体腔内引起感染后果是相当严重的。


The incision made in the tissue lining the cavity is sutured next, using the same type of suture material as the bladder. The muscular attachments to the cut piece of shell will gradually reestablish themselves to the underside of the cut piece.

    然后需要缝合体腔的开口，采用缝合膀胱的相同材料。壳下面的内膜肌腱组织也需要复原。


While all of this was going on the piece of shell that was removed at the beginning of the surgery was kept moist by wrapping it with sterile gauze soaked with saline. Doctor R is removing the gauze before putting the cut piece of shell back in place.

    把手术最初切割下的龟壳一直放在消毒盐水浸透的纱布里，医生把龟壳从纱布里拿出来然后放回乌龟身上原来的位置。


Now the fun of putting the shell back together begins. The previously removed piece of shell is put back into position and a piece of fiberglass is measured and cut so that it just covers the cut piece of shell.

    把龟壳放回当初切割的位置，同时切一块同样大小的玻璃纤维。


A special quick drying epoxy is poured on the shell. Once this epoxy hardens it can not be removed or reshaped, so we have to move fast.

    把速干的环氧树脂倒在龟壳上，如果环氧树脂变硬了哈就不能移动或者改变形变，所以动作要快。


It is spread evenly over the cut piece by two assistants. When it gets tacky we are ready for the next step.

    用2个小木片把环氧树脂抹匀在龟壳上，然后等到有些粘的时候进行下一步。

The fiberglass piece is placed over the sticky epoxy and another layer of epoxy is poured over the fiberglass and rapidly smoothed over the fiberglass.

    把那块同样大小的玻璃纤维放在龟壳上，在抹了环氧树脂变的有点沾的部位。再在上面倒点环氧树脂然后再抹平。


  The epoxy becomes firm within a few minutes. During this time it is important that the tortoise does not wake up or breathe deeply because the pressure in the lungs will push the patch out.

    几分钟后环氧树脂变的牢固了。这个时候乌龟还有醒或者有深呼吸因为肺部的气压啥子啥子哦不懂。

Cellophane is put over the patch as it dries for cleanliness and protection purposes

    把玻璃纸放在乌龟上用来清洁和保护。


Here is our friend just waking up from anesthesia. At this point we will give her a pain injection and place her in a special room that maintains a temperature of 85 degrees. She will stay in the hospital for a few days until she is eating and active.

    然后这个瓜乌龟就过了麻醉药醒了。这个时候给他打个止痛针然后放置在一个保持华氏85度的房间里面。在他开始吃东西和活动前他会在医院呆一些天。

afswafsw

:wub: :wub: :wub:

克邦

:wub: :wub:

超級马甲＿86

好强...

huangyi555

其实养龟技术含量很高

狗蛋儿

很专业

紫衫

:wub: :wub: :wub:

Ｓab

厉害!!