Kemeny M M, Cooke V, Melester T S, Halperin I C, Burchell A R, Yee J P, Mills C B
Department of Surgery, St Vincent's Hospital and Medical Center, New York City, New York.
AIDS. 1993 Aug;7(8):1063-7. doi: 10.1097/00002030-199308000-00006.
To study the effect of splenectomy in HIV-infected patients.
A retrospective chart review of patients admitted to St Vincent's Hospital who had splenectomies and were HIV-positive.
All patients were treated at St Vincent's Hospital, New York City, New York, USA.
Only patients who were HIV-positive and who had had a splenectomy at St Vincent's Hospital were included.
All patients had a splenectomy.
The effect of the splenectomy in these HIV-positive patients was studied with respect to their operative morbidity and mortality, platelet counts, overall survival and the development of new opportunistic infections.
All patients who did not have AIDS but did have thrombocytopenia responded to splenectomy in terms of their thrombocytopenia. None of them had an accelerated progression to AIDS. Most patients with AIDS and thrombocytopenia responded to splenectomy in terms of correcting their thrombocytopenia.
Splenectomy as a treatment for thrombocytopenia is successful not only in HIV-positive patients without AIDS, but also in AIDS patients. However, in patients with disseminated Kaposi's sarcoma or Mycobacterium avium intracellulare, splenectomy may not be a factor for survival.
研究脾切除术对HIV感染患者的影响。
对入住圣文森特医院并接受脾切除术且HIV呈阳性的患者进行回顾性病历审查。
所有患者均在美国纽约市纽约州的圣文森特医院接受治疗。
仅纳入在圣文森特医院接受脾切除术且HIV呈阳性的患者。
所有患者均接受了脾切除术。
研究脾切除术对这些HIV阳性患者的手术发病率和死亡率、血小板计数、总体生存率以及新机会性感染的发生情况的影响。
所有未患艾滋病但患有血小板减少症的患者，其血小板减少症对脾切除术有反应。他们均未加速发展为艾滋病。大多数患有艾滋病和血小板减少症的患者，其血小板减少症经脾切除术后得到纠正。
脾切除术作为治疗血小板减少症的方法，不仅对未患艾滋病的HIV阳性患者有效，对艾滋病患者也有效。然而，对于患有播散性卡波西肉瘤或鸟分枝杆菌感染的患者，脾切除术可能不是影响生存的因素。
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