Coon W W
Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109.
Am J Surg. 1988 Mar;155(3):391-4. doi: 10.1016/s0002-9610(88)80097-7.
Splenectomy was performed in 20 patients with refractory cytopenias associated with systemic lupus erythematosus. An immediate and sustained increase in platelet count (greater than 150,000 cells/mm3) was achieved in 12 of 18 patients whose principal indication for operation was thrombocytopenia. Of seven patients with hemolytic anemia, which was linked with thrombocytopenia in five, six had an increase in the hematocrit value of 20 percent or more after operation. The white blood count increased to normal values in three leukopenic patients. We believe that although removal of the spleen is not uniformly successful in correcting cytopenias in patients with systemic lupus erythematosus, splenectomy should be considered in patients refractory to other modalities of treatment.
对20例与系统性红斑狼疮相关的难治性血细胞减少症患者实施了脾切除术。在以血小板减少为主要手术指征的18例患者中，有12例术后血小板计数立即且持续升高（大于15万/mm³）。7例溶血性贫血患者中，5例与血小板减少相关，6例术后血细胞比容值升高20%或更多。3例白细胞减少症患者的白细胞计数升至正常水平。我们认为，尽管脾切除术在纠正系统性红斑狼疮患者的血细胞减少症方面并非都能成功，但对于其他治疗方式无效的患者应考虑进行脾切除术。
