门脉高压症脾切除术后持续性发热原因探讨

A Study on the causes of continuous postoperative fever in patients with portal hypertension after splenectomy

本文报告肝炎后肝硬变门静脉高压症手术伴脾切除者197例,术后持续性发热达2周以上者34例,占17.3％。其中由各种并发症引起发热者25例,占73.5％,不明原因发热者9例,占26.5％,为脾切除者的4.6％。25例中出现33例次并发症,以膈下及胸腔积液最多,占57.6％(19例次)。各种感染次之,占33.3％(11例次),门脾静脉血栓形成最少,占9.1％(3例次)。不明原因的发热与肝功能分级有关(P<0.01),而发热原因明确者主要由并发症引起,与肝功能分级无关。发热与术式无明显关系(P<0.05)。结论:术后持续性发热主要由各种并发症引起。

197 cases of hepatitis cirrhosis - induced portal hypertension and pertormed splenectomy were studied,34 caese of them(17. 3%) had a continuous postoperative fever that persisted more than 2 weeks. Among them 25 cases (73. 5%) were caused by various complications,and the cause of the other 9 cases (26. 5%) was unknown,which account for 4. 6% of all splenectomy. There were 33 complications in 25 cases,and the most common complications was the collective fluid in subdiaphragmatic space and thoracic cavity. And the second was a variety of infections,presented in 33. 3%(11 cases). Portal vein thrombosis formation was rare,accounted for 9. 1% (3 cases). There was a correlation between fever with unknown cause and liver function classes (P<0. 01),fever with identifed causes was caused mainly by complications and had no relationship to liver function classes. The fever was unrelated to operative procedures (P>0. 05). Our results showed that the continuous postoperative fever was mainly caused by the complications.