脾切除治疗血液病64例分析

目的探讨脾切除对血液病的治疗效果、适应证以及术后并发症。方法回顾分析1996年1至2008年1月哈尔滨医科大学附属第一临床医学院外科治疗64例血液病病人的临床资料，探讨脾切除对血液病的治疗效果、术后并发症及预防措施。结果脾切除对原发性血小板减少性紫癜、遗传性球形红细胞增多症、自身性免疫性溶血性贫血、真性红细胞增多症的治疗效果确切，有效率分别为84%、100%、60%和50%；对非霍奇金病、骨髓纤维化、慢性粒细胞白血病治疗效果欠佳。结论脾切除对内科治疗无效的良性血液病行之有效，对恶性血液系统疾病需慎重选择。

Splenectomy for hemmlogical disease:an analysis of 64 cases

Splenectomy for hematological disease:an analysis of 64 casesLIU Ji，SUN Bei，JIANG Hong chi，et al.Department of Hepatopancreato Biliary Surgery，the First Affiliated Hospital of Harbin Medical University，Harbin 150001,China Corresponding author：SUN Bei， E mail：sunbei70@tom.com AbstractObjectiveTo investigate the therapeutic efficacy,indications and postoperative complications of splenectomy in patients with hematological diseases.MethodsThe clinical data of 64 patients suffering from hematological diseases admitted between January 1996 and January 2008 at the First Affiliated Hospital of Harbin Medical University were analyzed retrospectively.The therapeutic efficacy,the postoperative complications and some preventive measures were discussed.ResultsSplenectomy could exert significant therapeutic effects on the diseases of idiopathic thrombocytopenic purpura (ITP),hereditary spherocytosis (HS),autoimmune hemolytic anemia (AHA) and polycythemia vera (PV).The effective rates were 84%,100%,60% and 50% respectively.But the treatment effects on the others diseases such as non Hodgkin′s lymphoma (NHL),myelofibrosis,chronic myelogenous leukemia were below the mark.ConclusionSplenectomy is effective on the benign hematological diseases whenever non surgical management is invalid.However,the malignant hematological diseases treated by splenectomy need to be choosed carefully.