Dickerman J D
J Trauma. 1976 Aug;16(08):662-8. doi: 10.1097/00005373-197608000-00012.
The risk of bacterial sepsis in the surgically or functionally asplenic host is reviewed. The lowest morbidity occurs in patients splenectomized because of trauma to the spleen; the highest morbidity occurs in patients splenectomized for thalassemia. There is approximately a 50% mortality associated with sepsis secondary to asplenia and the pneumococcus is responsible for over 50% of the cases. Normal spleen function and alteration in host defense occurring as a consequence of asplenia is discussed. Finally, alternatives to and indications for splenectomy as well as prophylactic measures are considered. It is concluded that, at the present time, antibiotic coverage for an indefinite period of time may be indicated for surgically or functionally asplenic patients.
本文综述了外科手术切除脾脏或功能性无脾宿主发生细菌性败血症的风险。因脾脏外伤而接受脾切除术的患者发病率最低；因地中海贫血而接受脾切除术的患者发病率最高。无脾继发败血症的死亡率约为50%，其中肺炎球菌导致的病例超过50%。本文还讨论了正常脾脏功能以及无脾导致的宿主防御改变。最后，探讨了脾切除术的替代方法、适应证以及预防措施。得出的结论是，目前对于外科手术切除脾脏或功能性无脾的患者，可能需要长期使用抗生素进行预防。
