84例脾切除治疗的临床观察及分析

Clinical Observation and Analysis on Splenectomy of 84 Cases

对84例脾切除进行临床观察及分析,结果显示特发性血小板减少紫癜和自身免疫性溶血性贫血术后有效率分别为83.3％和62.5％,遗传性球形细胞增多症和自身免疫性溶血性贫血术后血红蛋白平均分别升高52.5g/L和42.1g/L,在改善贫血方面,原发性脾机能亢进脾切除明显优于继发性脾机能亢进脾切除(P<0.025),肝硬化、胃癌脾切除对外周血细胞影响不大。此研究表明脾切除是治疗某些血液病的重要手段之一,对遗传性球形细胞增多症应首选,对脾机能亢进,特别是继发性脾机能亢进应慎重考虑。

The splenectomy in 84 cases was clinically observedand analysed. The results showed that the postoperative effective rates in 24 cases of ITP and 8 cases of AIHA were 83.3 % and 62.5 % respectively. The Hb levels in 7 cases of HS and 8 cases of AIHA were elevated with an average value of 52.6g/L and 42.1g/L respectively. In terms of improving anemia, Splenectomy in cases with primary hypersplenisrn was significantly superior to that in cases with secondary hypersplenism(P<0. 025). The spienectorny done to cases with cirrhosis and gastric carcinoma had not significant influence on peripheral blood cell. It can concluded that splenectomy is an important means of treating some hematological disease and should be the first choice for HS, as for hypersplenism, particularly for secondary hypersplenisrn, the resectional therapy should be done after careful consideration.