Spencer D D, Ragland J J, Limjoco U R, Rubio C E
Department of General Surgery, Naval Medical Center, San Diego, Calif 92134-5000, USA.
J Am Osteopath Assoc. 1995 Apr;95(4):257-60.
Splenectomy alone or in combination with other major operative procedures has been implicated as the cause of excessive morbidity and mortality. We retrospectively studied 151 consecutive patients with splenectomy performed between 1985 and 1992. Subsets of patients according to indication for splenectomy were compared with a cohort of patients having elective open cholecystectomy. Morbidity with elective splenectomy (11.5%) was not significantly increased over that with elective open cholecystectomy (6.8%). Morbidity with nonelective splenectomy (40.4%) was increased when compared with that of elective splenectomy (11.5%) or with elective open cholecystectomy (6.8%). Mortality was significantly worse for nonelective (10.6%) than for elective splenectomy (1%). Nonelective splenectomy should be recognized as one event in a cascade of events leading to excessive morbidity and mortality. Splenectomy should not be implicated as the sole or primary cause of such excesses.
单纯脾切除术或与其他主要手术联合进行被认为是导致发病率和死亡率过高的原因。我们回顾性研究了1985年至1992年间连续进行脾切除术的151例患者。根据脾切除指征将患者亚组与一组择期开腹胆囊切除术患者进行比较。择期脾切除术的发病率（11.5%）与择期开腹胆囊切除术的发病率（6.8%）相比没有显著增加。与择期脾切除术（11.5%）或择期开腹胆囊切除术（6.8%）相比，非择期脾切除术的发病率（40.4%）有所增加。非择期脾切除术的死亡率（10.6%）明显高于择期脾切除术（1%）。非择期脾切除术应被视为导致发病率和死亡率过高的一系列事件中的一个环节。脾切除术不应被认为是此类过高发病率和死亡率的唯一或主要原因。
