Coon W W
Arch Surg. 1985 May;120(5):625-8. doi: 10.1001/archsurg.1985.01390290099017.
In 113 patients with hemolytic anemia splenectomy was performed, without mortality and with minimal morbidity. Fifty-three patients with congenital spherocytosis and two with congenital elliptocytosis had postoperative increases in hematocrit to normal or near-normal levels. Three patients with pyruvate kinase deficiency and three with thalassemia variants were improved. Splenectomy in 52 patients with autoimmune hemolytic anemia resulted in an excellent response in 64% (no further steroid therapy) and an improved status in another 21% (prednisone requirements, 15 mg/day or less). For conditions other than congenital spherocytosis, in which splenectomy is uniformly of value, a decision to remove the spleen should be based on severity of the hemolytic process, failure to respond to other therapies, and the potential for achieving significant improvement in anemia and other associated cytopenias.
对113例溶血性贫血患者实施了脾切除术，无死亡病例，发病率极低。53例先天性球形红细胞增多症患者和2例先天性椭圆形红细胞增多症患者术后血细胞比容升至正常或接近正常水平。3例丙酮酸激酶缺乏症患者和3例地中海贫血变异型患者病情得到改善。52例自身免疫性溶血性贫血患者接受脾切除术后，64%（无需进一步使用类固醇治疗）效果极佳，另有21%（泼尼松需求量为每日15毫克或更低）病情改善。对于除先天性球形红细胞增多症（脾切除术对此病始终有效）以外的其他病症，是否切除脾脏的决定应基于溶血过程的严重程度、对其他治疗方法无反应以及贫血和其他相关血细胞减少症显著改善的可能性。
