Musser G, Lazar G, Hocking W, Busuttil R W
Ann Surg. 1984 Jul;200(1):40-5. doi: 10.1097/00000658-198407000-00006.
Between 1956 and 1981, 306 splenectomies for hematologic diseases were performed at the UCLA Medical Center. Of these operations, more than 75% were performed for therapeutic reasons to control anemia, thrombocytopenia, neutropenia, or painful symptoms of splenomegaly. Of the 65 patients who had idiopathic thrombocytopenic purpura, 77% showed an excellent response, and of the 39 patients who had hereditary spherocytosis, 90% responded. Other diseases with predictably good response rates were autoimmune hemolytic anemias, Felty's syndrome, and hairy cell leukemia. Forty patients with Hodgkin's disease had splenectomies for diagnostic purposes the last 10 years. The overall morbidity and mortality were 24% and 6%, respectively, the most common complications being pneumonia, wound infections, and local postoperative bleeding, and the most common cause of death being sepsis. The review supports the thesis that in carefully selected patients, therapeutic splenectomy can have desirable palliative effects and that diagnostic splenectomy has a sufficiently low risk to warrant its consideration in patients with Hodgkin's disease.
1956年至1981年间，加州大学洛杉矶分校医学中心针对血液系统疾病实施了306例脾切除术。在这些手术中，超过75%是出于治疗目的，以控制贫血、血小板减少、中性粒细胞减少或脾肿大引起的疼痛症状。在65例患有特发性血小板减少性紫癜的患者中，77%有良好反应；在39例患有遗传性球形红细胞增多症的患者中，90%有反应。其他反应率可预测良好的疾病包括自身免疫性溶血性贫血、费尔蒂综合征和毛细胞白血病。在过去10年里，40例霍奇金病患者接受了脾切除术用于诊断目的。总体发病率和死亡率分别为24%和6%，最常见的并发症是肺炎、伤口感染和术后局部出血，最常见的死亡原因是败血症。该综述支持这样的观点：在经过精心挑选的患者中，治疗性脾切除术可产生理想的姑息效果，并且诊断性脾切除术风险足够低，值得在霍奇金病患者中考虑。
