功能亢进病理性脾脏切除对机体免疫功能影响的研究进展  

Research Progress in Effect of Resection of Pathological Hyperfunctional Spleen on Immune Function

作　　者：郑奕菲 侯化南 戚士芹[1,2] ZHENG Yifei;HOU Huanan;QI Shiqin(The Fifth Clinical Medical College of Anhui Medical University,Hefei 230032,China;Department of General Surgery,Anhui Provincial Children′s Hospital,Hefei 230051,China;Department of General Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第五临床医学院,合肥230032 [2]安徽省儿童医院普外科,合肥230051 [3]安徽医科大学第一附属医院普外科,合肥230022

出　　处：《医学综述》2024年第3期345-351,共7页Medical Recapitulate

摘　　要：脾功能亢进(简称脾亢)常见于门静脉高压症、血液疾病或代谢性疾病,对免疫系统产生显著影响。在治疗脾亢的过程中,尤其是在考虑是否进行脾脏切除时,存在两种不同的观点:保脾观点强调脾脏切除可能导致免疫功能降低,增加患者感染和肝肿瘤的发生风险,以及可能引发门静脉系统血栓;而支持脾脏切除者认为这一措施不仅能有效降低门静脉压力、减少消化道出血、纠正血细胞减少症状,还能改善免疫功能、促进肝脏细胞再生、改善肝功能,甚至抑制肝纤维化的进展。因此综合研究生理性和病理性脾脏的免疫功能,以及脾脏切除术后对机体免疫功能的影响,对于指导病理性脾亢的临床治疗和决策具有重要意义。Hypersplenism is a common condition in portal hypertension,hematological disorders,or metabolic disorders,which has a significant impact on the immune system.There are two different perspectives in the treatment of hypersplenism,especially when considering whether to perform splenectomy:the viewpoint of preserving the spleen emphasizes that splenectomy may lead to a decrease in immune function,increase the risk of infection and liver tumors in the patients,and may cause portal vein thrombosis;supporters of splenectomy believe that this measure not only effectively reduces portal vein pressure,reduces gastrointestinal bleeding,corrects symptoms of decreased blood cells,but also improves immune function,promotes liver cell regeneration,improves liver function,and even inhibits the progression of liver fibrosis.Therefore,integrated studies of the immune function of physiological and pathological spleen,as well as the impact of splenectomy on the body′s immune function,are of great significance for guiding the clinical treatment and decision-making of pathological hypersplenism.

关 键 词：脾功能亢进 免疫功能 全脾切除 脾动脉栓塞 

分 类 号：R657.6[医药卫生—外科学]