门脉高压症脾切除术后持续发热原因探讨

Discussion on the Cause of Persistent Fever after Splenectomy due to Portal Hypertension

目的 探讨门脉高压症脾切除术后持续发热的原因。方法 回顾性分析 1984～ 2 0 0 1年 2 2 7例行门脉高压症手术伴脾切除术病例的临床资料。结果 2 2 7例中术后出现持续性发热 2周以上者 3 9例 ,占17 2 % ( 3 9/2 2 7) ,其中由各种并发症引起发热者 2 9例 ,占 74 3 % ( 2 9/3 9) ,不明原因发热者 10例 ,占2 5 7% ( 10 /3 9)。 2 9例中出现 3 6例次并发症 ,以膈下及胸腔积液最多 ,占 5 2 8% ( 19/3 6) ,感染性并发症次之 ,占 3 8 9% ( 14 /3 6) ,门脾静脉血栓形成最少 ,占 8 3 % ( 3 /3 6)。不明原因的发热与肝功能分级有关 (P <0 0 1) ,而发热原因明确者由并发症引起 ,与肝功能分级无关。发热与术式无明显关系 (P >0 0 5 )。结论 术后持续发热原因主要由各种并发症引起。

Objective To discuss the cause of persistent fever after splenectomy due to portal hypertension. Methods 227 patients who underwent splenectomy due to portal hypertension from1984 to 2001 were retrospectively studied. Results 39 of 227 patients (17 2%) had fever lasting over 2 weeks including 29 cases(74 3%) caused by the complications and 10 cases (25 7%)caused by unknown reasons. The whole complications occurred in the 29 patients were 36 person time, with hydrothorax and subphrenic fluid (52 8%), infection (38 9%) and selenoportal thrombosis (8 3%). The unknown reason fever was related to the grade of liver function. The fever which had obvious reasons was caused by complications and had nothing to do with the grade of liver function. There was no association between the methods of operation and fever. Conclusion The complications were the main reasons of persistent fever after splenectomy.