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本文报告30例小儿地贫脾切除后的远期疗效观察。其中18例为重型8地贫,12例为HbH 病。脾切除时年龄3岁以上23例,2岁以下7例,最小1例为9个月。经4～20年的追踪观察结果表明,脾切除对地贫改善贫血、减少输血有一定疗效。HbH 病组,术后红细胞平均增加113.3万/mm~3,Hb 平均增加3.2克/dl(P<0.05):重型β地贫组:红细胞平均增加77.4万/mm~3,Hb 平均增加2.4克/dl(P<0.01):贫血改善情况,两组疗效相似(P>0.05)。术前均需经常输血,术后22例(77.3%)均未再输血。术后半数病例细胞免疫功能低下,部分病例有体液免疫功能异常.HbH 病组术后生长发育多数良好,但重型β地贫多数较差。现年20岁以上7例已能参加生产劳动.
This article reports the long-term efficacy of 30 cases of pediatric thalassemia splenectomy. Among them, 18 were severe 8 thalassemia and 12 were HbH. Splenectomy at the age of 3 years old 23 cases, 2 years of age in 7 cases, the smallest one case of 9 months. After 4 to 20 years of follow-up observation showed that splenectomy on thalassemia to improve anemia, reduce blood transfusions have a certain effect. In HbH group, the number of erythrocytes increased by 1.133 million / mm ~ 3 after surgery and the average Hb increased by 3.2 g / dl (P <0.05). In severe β thalassemia group, the average number of erythrocytes increased by 774,000 / mm ~ /dl(P<0.01): anemia, the two groups were similar (P> 0.05). Blood transfusions were required before surgery, and no blood transfusion occurred in 22 patients (77.3%) after operation. In half cases, cellular immune function was poor, and some cases had humoral immune dysfunction.HbH patients had the most good postoperative growth and development, but most of the severe β-thalassemia was poor. 7 years old above the age of 20 have been able to participate in productive labor.