Engelhardt M, Haas P S, Theilacker C, Eber S W, Schmugge M, Kern W V, Heimpel H
gleichberechtigte Erstautoren, Medizinische Universitätsklinik, Innere Medizin I (Hämatologie und Onkologie), Freiburg.
Dtsch Med Wochenschr. 2009 Apr;134(17):897-902. doi: 10.1055/s-0029-1220231. Epub 2009 Mar 31.
Overwhelming Post-Splenectomy Infection (OPSI or PSS), most frequently caused by encapsulated Gram-positive pathogens, is a complication after splenectomy. Reasons for splenectomy include trauma, or malignant and non-malignant hematologic diseases. OPSI-inducing bacteria are mainly Streptococcus pneumoniae and less frequently Haemophilus influenzae, Neisseria meningitides and Gram-negative bacilli. There exist very efficient--albeit often neglected--strategies, how to prevent infections in patients after splenectomy. These include vaccination, prophylactic antibiotics (always for 3 years during childhood and adolescence) and prompt antibiotic treatment, if an infection is suspected. Patients need to know the nature and likelihood of PSS and they should seek immediate medical attention if they become ill or febrile. Each patient should carry at all times a letter or card documenting the splenectomy. With these measures and precautions, the PSS-risk can be significantly reduced or at best be completely avoided.
脾切除术后暴发性感染（OPSI或PSS），最常见由包膜革兰氏阳性病原体引起，是脾切除术后的一种并发症。脾切除的原因包括创伤、恶性和非恶性血液系统疾病。引发OPSI的细菌主要是肺炎链球菌，较少见的有流感嗜血杆菌、脑膜炎奈瑟菌和革兰氏阴性杆菌。对于如何预防脾切除术后患者感染，存在一些非常有效的策略——尽管常常被忽视。这些策略包括接种疫苗、预防性使用抗生素（儿童和青少年时期需持续3年）以及如果怀疑感染则及时进行抗生素治疗。患者需要了解PSS的性质和可能性，并且如果生病或发热应立即就医。每位患者应随时携带一份记录脾切除情况的信件或卡片。通过这些措施和预防手段，PSS风险可显著降低，最好能完全避免。
