摘要
本文报道消灭血吸虫病已２０年的上海县华漕乡１９５２～１９７４年查出的２３２例晚期血吸虫病的历年随访和１９９１年回顾性调查结果。发现１０～４０年前脾切除的１３５例的生存率（１００／１３５，７４．１％）明显高于未切脾组（１７／９７，１７．５％）。按切脾时年龄分２组分析：３５岁以下切脾和３６岁以上切脾患者的累积生存率分别为９３．７％（５９／６３）和５６．９％（４１／７２）（Ｐ＜０．０１），生存曲线的７５％存活年限分别为手术后３４．２和１７．７年，表明早期脾切除多数患者能完全恢复健康，享有和正常人群相似的生活和寿命。切脾组的并发症和病死率明显低于未切脾组，因上消化道出血死亡率分别为３％和６．２％，腹水肝衰死亡率分别为５．９％和１７．５％，死于肝硬化无关病因分别为１０．４％和４９．５％，提示脾切除不仅能防止门脉高压并发症，且能改善患者全身状态，特别是早期切脾患者预后明显较晚期切脾者为佳。
A long-term follow-up study on 232 patients of advanced schistosomiasisfound successively from 1952-1974 in Hua-Cao Township , Shanghai suburb,where schistoso-miasis had been eradicated during the last more than 20 years, was carried out in the period of1956-1991.The cumulative survival rate in 135 patients who had splenectomy 10-40(25.5±5.3)years before was much higher than that of 97 patients without splenectomy(74.1%vs 17.5%)in corresponding period. Among the splenectomized patients, both the cumulative survivalrate and the 75%survival time (year)of the survival curve were found considerably higher(93.7%vs 56.9%)and longer(34.2 vs 17.7 years)in those who were operated before age of 35 thanthose operated between the age of 36-58, indicating that the patients of schistosomal cirrhosiscould completely recover from their illness and enjoy the same life as the normal if splenectomy isperformed early and without reinfection. The complications and mortality due to hepatic cirrhosisas well as to non-liver-related factors were significantly lower in the splencetomy group thanthat of non-operative group,suggesting that splenectomy not only prevented the complication ofportal hypertension,but might also improve patients’general health and resistance against otherpathogens.
出处
《中国寄生虫病防治杂志》
CSCD
1994年第3期190-193,共4页
Chinese Journal of Parasitic Disease Control
关键词
生存率
血吸虫病
防治
Advanced schistosomiasis splenectomy survival rate
