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首页> 外文期刊>journal, indian academy of clinical medicine >Study of hypersplenism and effect of splenectomy on patients with hypersplenism
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Study of hypersplenism and effect of splenectomy on patients with hypersplenism

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Objectives: To determine the occurrence of hypersplenism among patients with splenomegaly, to study its aetiology, and correlate its severity with the degree of splenomegaly; and to study the response to splenectomy in patients with hypersplenism. Design of study: A prospective study of adult patients of splenomegaly admitted over a period of ten months. Setting: Medical wards of a large teaching hospital in South India. Subjects: 100 adult patients. Results: One hundred adult patients with splenomegaly were studied. Hypersplenism was observed in 28 patients. The causes of hypersplenism in them were non-cirrhotic portal fibrosis (9, i.e., 32.2), cirrhosis of liver (8, i.e., 28.6), hyper-reactive malarial splenomegaly (HMS) (7, i.e., 25) and chronic hepatitis (2, i.e., 7.1); and a small number of patients formed an idiopathic group (2, i.e., 7.1). Though the prevalence of hypersplenism increased with increasing spleen size (p < 0.0001), there was no significant correlation between splenic size and severity of hypersplenism. Splenectomy, performed in sixteen such patients with hypersplenism, besides resulting in improvement in cell count of all three haematopoietic cell lines, caused transient leucocytosis and thrombocytosis in 16(100) and 5 (31.25) patients respectively. Conclusions: Hypersplenism may be observed in about one-fourth of patients with splenomegaly. Congestive splenomegaly due to hepatic cause is likely to be the major cause in our setting. All definite cases of hypersplenism are likely to respond to splenectomy, even with an overresponse in some instances.

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