White K S, Covington D, Churchill P, Maxwell J G, Norman K S, Clancy T V
Department of Surgery, University of North Carolina, School of Medicine, Chapel Hill.
Am J Infect Control. 1991 Feb;19(1):36-41. doi: 10.1016/0196-6553(91)90158-9.
Sepsis after splenectomy is a lifelong risk, and patients who have had splenectomy should be educated about this risk. This study examines patient knowledge after splenectomy. We reviewed hospital records of 118 patients who had splenectomies performed between 1982 and 1988 at New Hanover Memorial Hospital. Twenty-four patients have died since their surgery; one death was suspected to be due to postsplenectomy sepsis. Of the 89 patients alive and eligible for follow-up, we were able to query 63. Only 16% were aware of any health precautions. After prompting, patient awareness improved to 40%. We also surveyed 11 of the 14 surgeons who performed the splenectomies. They indicated that they always discuss with their patients the immunologic consequences of spleen removal and the increased risks of infection, although they do not always recommend pneumococcal vaccine. We conclude that splenectomy patients have a low level of knowledge about postsplenectomy infection risks and precautions. We developed an educational pamphlet to aid the surgeon in patient education.
脾切除术后发生败血症是一种终身风险，应对接受过脾切除术的患者进行该风险教育。本研究调查了脾切除术后患者的相关知识。我们查阅了1982年至1988年在新汉诺威纪念医院接受脾切除术的118例患者的医院记录。自手术以来，有24例患者死亡；其中1例死亡疑似因脾切除术后败血症所致。在89例存活且符合随访条件的患者中，我们成功询问了63例。只有16%的患者知晓任何健康预防措施。经提示后，患者知晓率提高到了40%。我们还调查了实施脾切除术的14名外科医生中的11名。他们表示，他们总是会与患者讨论脾切除的免疫后果以及感染风险增加的问题，尽管他们并不总是推荐接种肺炎球菌疫苗。我们得出结论，脾切除术后患者对术后感染风险和预防措施的了解程度较低。我们编写了一份教育手册，以协助外科医生对患者进行教育。
