Stevović D, Dugalić D, Pesko P, Petrović M, Zuvela M, Kovacević P
Acta Chir Iugosl. 1989;36(2):257-67.
This study analyses frequency of complications and mortality after elective splenectomy done for various hematological diseases, dependent on the spleen weight. From 1979 to 1988 year, 236 patients were treated by splenectomy for various haematological disorders, including: autoimmune disorders (90), Hodgkin's disease (34), lymphoproliferative diseases (96) and myeloproliferative diseases (16 patients). In the early postoperative period, complications occurred in 51 (21.61%) patients, 10 of which (4.24%) died. Considering the size of the spleen (more or less than 1500 gr) there was no difference in the early postoperative mortality (p greater than 0.05; 3.30%:5.38%), while postoperative complications occurred significantly more often in patients with massive splenomegaly (p greater than 0.05; 1259%:3548%). The most frequent complications were septical (8.90%), prolonged fever (5.51 x), and postoperative bleeding (2.97%), while cardial, pulmonary and urinary complications occurred seldom, but more often caused patient's death. Defining the appropriate indications for splenectomy, performing suitable preoperative preparations and postoperative care, mortality was diminished from 7.14% in the period, 1979-1983 year, to 2.17% in the period 1984-1988.
本研究分析了因各种血液系统疾病行择期脾切除术后并发症的发生频率及死亡率，该频率及死亡率取决于脾脏重量。1979年至1988年期间，236例患者因各种血液系统疾病接受了脾切除术，这些疾病包括：自身免疫性疾病（90例）、霍奇金病（34例）、淋巴增殖性疾病（96例）和骨髓增殖性疾病（16例）。术后早期，51例（21.61%）患者出现并发症，其中10例（4.24%）死亡。考虑脾脏大小（大于或小于1500克），术后早期死亡率无差异（p大于0.05；3.30%:5.38%），而巨脾患者术后并发症的发生明显更频繁（p大于0.05；1259%:3548%）。最常见的并发症是败血症（8.90%）、持续发热（5.51x）和术后出血（2.97%），而心脏、肺部和泌尿系统并发症很少发生，但更常导致患者死亡。明确脾切除术的合适适应证、进行适当的术前准备和术后护理后，死亡率从1979 - 1983年期间的7.14%降至1984 - 1988年期间的2.17%。
