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通常，國際上臨床的處理，對於肝硬化造成的紅，白細胞，血小板低落不做”治療“，更不會切除脾臟。如果紅細胞太低可以輸紅細胞或用Epogen/Procrit提高紅細胞，刺激生長。白細胞過低可以注射Neupogen。
脾臟摘除應該避免，因爲末期肝臟疾病手術的感染，出血和麻醉上的危險是未知數，對於失代償期患者很危險。
Hypersplenism. The filtration of blood by an enlarged spleen usually results in only mild reductions of red blood cells (anemia), white blood cells (leukopenia) and platelets (thrombocytopenia) that do not require treatment. Severe anemia, however, may require blood transfusions or treatment with erythropoietin or epoetin alfa (Epogen, Procrit), hormones that stimulate the production of red blood cells. If the numbers of white blood cells are severely reduced, another hormone called granulocyte-colony stimulating factor is available to increase the numbers of white blood cells. An example of one such factor is filgrastim (Neupogen).
No approved medication is available yet to increase the number of platelets. As a necessary precaution, patients with low platelets should not use aspirin or other nonsteroidal antiinflammatory drugs (NSAIDS) since these drugs can hinder the function of platelets. If a low number of platelets is associated with significant bleeding, transfusions of platelets usually should be given. Surgical removal of the spleen (called splenectomy) should be avoided, if possible, because of the risk of excessive bleeding during the operation and the risk of anesthesia in advanced liver disease. |
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发表于 2010-8-24 12:28
