Najean Y, Messian O
Presse Med. 1983 Oct 22;12(37):2307-10.
Twenty-five patients with severe renal impairment treated by periodical haemodialysis underwent splenectomy (for spleen injury or tuberculosis in 2). All have been on long-term follow-up. At present, 7 patients have not improved; 7 are no longer transfused but remain anaemic with a less than 20% haematocrit; 11 have a more than 20% haematocrit without transfusion. Statistical analysis of the data shows that splenectomy, when effective, acts by reducing excess plasma volume and excessive haemolysis. Red cell production is not increased. The beneficial effect of splenectomy cannot be predicted from age, sex, cause of renal impairment or severity of anaemia. However, in this series there was a positive correlation between the degree of haemolysis, the site of red cell sequestration, the size of the spleen and the effectiveness of splenectomy. Infection, notably septicaemia in grafted (and immunodepressed) patients is a major risk of splenectomy and requires preventive measures.
25例接受定期血液透析治疗的严重肾功能损害患者接受了脾切除术（其中2例因脾损伤或结核病）。所有患者均接受长期随访。目前，7例患者病情未改善；7例不再输血，但仍贫血，血细胞比容低于20%；11例血细胞比容超过20%且无需输血。数据统计分析表明，脾切除术若有效，其作用机制是减少过多的血浆量和过度溶血。红细胞生成并未增加。脾切除术的有益效果无法根据年龄、性别、肾功能损害原因或贫血严重程度来预测。然而，在本系列研究中，溶血程度、红细胞滞留部位、脾脏大小与脾切除术的有效性之间存在正相关。感染，尤其是移植（且免疫抑制）患者的败血症，是脾切除术的主要风险，需要采取预防措施。
