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早在1659年Malphighi通过脾脏显微镜下解剖的观察,即确切地认为脾脏是一个血管系统的器官。经过近两个世纪临床上的探索,脾切除对某些血液疾病的治疗作用已逐步得到肯定。20世纪中叶以来,人们开始从病理生理学角度研究脾脏在某些血液疾病发病过程中的作用,为这些血液疾病的脾切除治疗提供了新的理论依据。脾源性血液疾病的发病机制 1.溶血:据William等观察,正常情况下红细胞在脾内破坏不超过20%,脾切除后未发现红细胞寿命延长。但是,当脾脏肿大时,脾索内红细胞容量增加,压积增高,红细胞的高度拥挤及脾索内的缓慢血流形成了对红细胞有害的代谢环境,使其膜稳定性降低,破坏增加。
As early as 1659, Malphighi dissected through a splenic microscopic observation that the spleen is thought to be an organ of the vasculature. After nearly two centuries of clinical exploration, splenectomy for the treatment of certain blood diseases have been gradually confirmed. Since the middle of the 20th century, people began to study the role of the spleen in the pathogenesis of certain blood diseases from the perspective of pathophysiology, providing a new theoretical basis for the splenectomy treatment of these blood diseases. Pathogenesis of spleen-derived blood diseases 1. Hemolysis: According to William et al observed that under normal circumstances, destruction of red blood cells in the spleen is not more than 20%, after splenectomy did not find the life span of red blood cells. However, when the spleen is enlarged, the capacity of the red blood cells in the splenic cord is increased, the pressure is increased, the highly crowded red blood cells and the slow blood flow in the splenic cord form a metabolic environment detrimental to erythrocytes, resulting in decreased membrane stability and increased destruction.