脾切除术后的反复性肺炎球菌脑膜炎

• 作 者: M.Gerwig A.Wittkmper U.Liebetrau J.-N.Petrovici 武忠弼
• 机 构: Neurologische Klinik,Kliniken der Stadt Kln,Ostmerheimer Str.200,D-51109 Kln,Germany,同济医科大学,
• 出 处: 德国医学
• 发表日期: 1996年02期
• 关键词: 脾切除术 肺炎球菌脑膜炎 何杰金病 系统性红斑狼疮 肺炎链球菌 菌血症 耳炎 急性经过 暴发性 肺炎球菌疫苗

特发性血小板减少性紫癜(Werlhof 病)、何杰金病和系统性红斑狼疮(LED)为脾切除的适应证。在 Werlhof 病时,80%患者可由此获得缓解,但对于 LED 时的自身免疫性血小板减少症则尚有争论。脾切除后的并发症之一为暴发性的、往往致命的败血症,亦称为 Opsi 综合征。此时由于血中含菌量甚高,故病程呈极急性经过。80%患者的致病菌为肺炎链球菌,最常见的感染为肺炎、脑膜炎及耳炎。预后险恶,20%患者以菌血症告终,至今仍然如此。

Idiopathic thrombocytopenic purpura (Werlhof disease), Hodgkin’s disease and systemic lupus erythematosus (LED) as indications of splenectomy. In Werlhof’s disease, 80% of patients can thus get relief, but there is still controversy about autoimmune thrombocytopenia at LED. One of the complications after splenectomy is an outbreak, often deadly sepsis, also known as Opsi syndrome. At this time due to high blood levels of bacteria, so the course was extremely acute. 80% of patients with pathogenic bacteria Streptococcus pneumoniae, the most common infections are pneumonia, meningitis and otitis media. The prognosis is sinister, with 20% of patients ending in bacteremia, still so.