Tsuji H, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University.
Nihon Rinsho. 1994 Jan;52(1):85-90.
Hypersplenism is defined as the association of anemia, leukopenia, or thrombocytopenia with bone marrow hyperplasia and splenomegaly. Hypersplenism is common in liver cirrhosis and frequent in patients with portal hypertension. The effects of portacaval shunt are variable; hypersplenism hardly ever improves but rarely develops after surgery. Since the spleen is a major component of the mononuclear phagocyte system, splenectomy reduces antibody synthesis. Although splenectomy abolishes hypersplenism, it may lead to sepsis. Recently, partial splenic embolization, using gelform injected directly into the splenic artery, has been performed in patients with cirrhosis. Partial splenic embolization induces an increase in the number of circulating blood cells. In addition, the levels of albumin, hepaplastintest, cholesterol and cholinesterase are increased significantly after treatment. Partial splenic embolization rarely causes problems and may actually be beneficial.
脾功能亢进的定义为贫血、白细胞减少或血小板减少与骨髓增生及脾肿大相关。脾功能亢进在肝硬化中常见,在门静脉高压患者中也较为频繁。门腔分流术的效果不一;脾功能亢进几乎不会改善,但术后很少发展。由于脾脏是单核吞噬细胞系统的主要组成部分,脾切除术会减少抗体合成。虽然脾切除术可消除脾功能亢进,但可能导致败血症。最近,已对肝硬化患者进行了直接向脾动脉注射明胶海绵的部分脾栓塞术。部分脾栓塞术可使循环血细胞数量增加。此外,治疗后白蛋白、肝促凝血酶原激酶试验、胆固醇和胆碱酯酶水平显著升高。部分脾栓塞术很少引起问题,实际上可能有益。