Ogawa Y, Kobayashi M, Saku M, Yo S, Iwaki A
Jpn J Surg. 1974 Mar;4(1):21-8. doi: 10.1007/BF02471378.
During the past 27 years from 1944 to 1970 splenectomy was performed on 53 patients including 33 idiopathic thrombocytopenic purpura (ITP), 13 hereditary spherocytosis and 7 hypoplastic anemia. Their clinical and laboratory findings in immediate and late postoperative periods were compared with those received medical treatment alone. In the chronic form of ITP the effect of medical treatment alone is only transitory and not curative. Splenectomy seems to be the treatment of choice in this situation which produces long term favorable results regardless of patient's response to preoperative steroid treatment. In hereditary spherocytosis the improvement in the morphology of red blood cells was limited after splenectomy, but considerable improvement was achieved in hemolytic tendency. Therefore, splenectomy would be the first choice. In hypoplastic anema splenectomy did not produce, in general, favorable results as compared in ITP or hereditary spherocytosis. However, when the patient responded to steroid treatment preoperatively, splenectomy could have reduced the frequency and amount of blood transfusion. Splenectomy would then be contemplated in such situations.
在1944年至1970年的过去27年中，对53例患者实施了脾切除术，其中包括33例特发性血小板减少性紫癜（ITP）、13例遗传性球形红细胞增多症和7例再生障碍性贫血。将他们术后即刻和远期的临床及实验室检查结果与单纯接受药物治疗的患者进行了比较。在慢性ITP中，单纯药物治疗的效果只是暂时的，并非治愈性的。在这种情况下，脾切除术似乎是首选的治疗方法，无论患者对术前类固醇治疗的反应如何，都能产生长期良好的效果。在遗传性球形红细胞增多症中，脾切除术后红细胞形态的改善有限，但溶血倾向有相当大的改善。因此，脾切除术将是首选。在再生障碍性贫血中，一般来说，与ITP或遗传性球形红细胞增多症相比，脾切除术并未产生良好的效果。然而，当患者术前对类固醇治疗有反应时，脾切除术可以减少输血的频率和输血量。在这种情况下，就会考虑进行脾切除术。
