摘要
目的探讨改良式脾脏次全切除术对治疗地中海贫血综合征的疗效。方法自2000年1月至2004年6月对我科行改良性脾脏次全切除术的26例地中海贫血综合征患者进行回顾性分析。结果1例极重度贫血合并心功能不全患者,术后因心功能衰竭死亡。3例出现肺部感染,经抗感染治疗后治愈。其余患者未出现腹腔出血,膈下积液,膈下脓肿及切口感染等并发症。术后随访19例,随访率73%,随访时间6～50个月平均21个月。术后3个月复查血常规,发现RBC,WBC,及PLT均有明显改善。5例反复出现肺部感染,但无凶险性感染。10例仍需间歇输血。结论改良式脾脏次全切除术适应症为严重地中海贫血综合征及巨脾并有脾功能亢进。本手术能起到减少血细胞在脾脏中的破坏,使部分病人在随访期内不需输血,而部分病人可减少输血次数和输血量。同时,能减少脾脏切除后引起免疫功能的下降。
Objective To investigate the efficacy of modified subtotal splenectomy for the treatment of the Mediterranean anemia syndrome.Methods From January 2000 to June 2004,26 Cases with Mediterranean syndrome.Methods From January 2000 to June 2004,26 cases with Mediterranean anemia syndrome received modified subtotal splenectomy were analyzed retrospectively.Results 1 cases with severe anemia associated with heart function insufficiency died from heart failure after operation.Pulmonary infection was heppened in 3 cases.No abdominal bleeding,subdiaphragmatic dropsy, subdiaphragmatic abscess and wound infection were found after oepration.Postoperative follow- up was obtained in 19 cases.The follow-up rate was 73%.Follow-up time was 6 to 50 months（average 21 months）.In the re-examination of blood routine after operation 3 months,the RBC,WBC and PLT were improved obviously.Pulmonary infection was occurred intermitantly in 5 cases,but no OPSI was found.Intermitatnt blood transfusion was needed still in 10 cases.Conclusion Operative indications of modified total splenectomy are severe Mediterranean anemia syndrome or splenomegaly （huge spleen） associated with hypersplenism.This procedure can reduce destruction of blood cells in the spleen.The blood transfusion is not neccesary to partial patients during follow-up period and while other residual patients can reduce the frequence and amount of blood transfusion.At the same time, it can reduce the decline of immunologic functiion after splenectomy.
出处
《岭南现代临床外科》
2005年第3期197-198,共2页
Lingnan Modern Clinics in Surgery
关键词
脾脏次全切除术
地中海贫血综合征
疗效
Subtotal splenectomy
Mediterranean anemia syndrome
Curative effect
