249例巨脾型晚期血吸虫病人脾脏切除后转归情况分析

The Outcomes of Advanced Schistosomiasis with Splenomegaly Following Splenectomy:A Report of 249 Cases

目的总结巨脾型晚期血吸虫病人脾切除术后的转归情况,探讨术后并发症的原因及其处理原则。方法收集我院1996-2006年249例脾切除患者的临床资料,对术后的转归情况及并发症的原因进行分析。结果术后病人的存活率为98.4%,并发症的出现率为13.65%,除4例患者因肝功能严重损害并出现黄胆而死亡外,其它并发症患者经对症综合处理后,病情好转出院。结论巨脾型晚血患者行切脾手术后,常发生并发症,需要密切观察和及时的对症处理。

Objective To investigate the outcome of postsplenectomy complications in patients with portal hypertension. Method Clinical data of 249 patients with advanced schistosomiasis portal hypertension undergoing splenectomy from 1996 to 2006 were retrospectively analyzed. Result 34 patients suffered from complications postoperatively. 4 patients died of liver dysfunction, 4 patients suffered from intra-abdominal hemorrhage, 2 patients suffered from subphrenic abscess, 13 patients suffered from pleural effussion and fever, 5 patients suffered from upper gastrointestinal hemorrhage, 2 patients suffered from infection of incisional wound, and 2 patients suffered from hepatic encephalopathy. Through combined therapy, pathological conditions were improved. Conclusion Postsplenectomy complications in patients with advanced schistosomiasis portal hypertension are common. Observing patients＇ condition closely and managing complications in time can save patients＇ life.