脾切除术后发热的临床分析

Clinical analysis of the fever after total splenectomy

目的 探讨全脾切除术后持续发热的原因及诊治措施。方法 回顾我院1991年至2006年306例行脾切除术后持续发热病人的临床资料，对体温〉38℃持续2周以上的102例病人的发热原因及诊治措施进行分析。结果 除61例不明原因发热外，其余41例与术后并发症有关。以膈下感染、切口感染、门静脉血栓形成为术后发热的常见原因。结论 全脾切除术后预防膈下感染、切口感染、门静咏血栓形成是减少术后持续发热的关键，对原因不明者考虑与免疫功能紊乱有关。

Objective To discuss the causations of the fever after total spleneetomy and the diagnosis and treatment. Methods Clinical data of the 102 cases whose temperature were above 38 ℃ went on two weeks postoperative out of 306 durative fever patients undergoing the surgery during the year 1991 -2006 were retrospectively reviewed, we analysed the reasons and the diagnosis and treatment＇ s management. Results There were 41 cases were related with postoperative syndromes except the other 61 patients. The most familiar causations were subdiaphragm infection, incision infection and portal vein thrombus. Conclusion The prevention of subdiaphragm infection,incision infection and portal vein thrombus is the sticking point to reduce postoperative＇ s durative fever. The others are unknown may have some relations with immune turbulence.