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鬱血性脾腫에 關한 硏究

Study on Congestive Splenomegaly

대한의학협회지 1963년 6권 5호 p.501 ~ 520
송태섭 (  ) - 서울대학교 의과대학 내과학교실

Abstract


Foruty cases with congestive splenomegaly were studied clinically and with laboratory features before and after simple splenectomy (34 cases)and splenorenal shunt (6 cases). These were controlled at the medical dept., the National Medical Center, in the period between January, 1959 and August, 1962.
The summary of the result found in this study is as follows:
1) Cases were most frequent between 10~39 years of age.
Male sex was predominant over female (1.7:1).
2) It seems that alcohol. malaria and syphilis have no direct relation to the disease. Hookworm infestation was found in relatively high percentage.
3) Splenomegaly was found in all cases, and hepatomegaly was noted in 37.5 oercebtage,
4) The pre-operative values of hemoglobin and red blood corpuscles were lower than normal. All of them improved post-operatively.
Leucopenia was present in 90% of cases and thrombocytopenia in all cases, except one. Post-operatively, the values increased above normal and gradually returned tonormal.
Thus, the disappearance of pancytopenia after operation may be ascribed to the removal of hypersplenism.
Sedimentation rate was found to be normal in 27 cases (67.5%), Increased values showed no remarkable change after operation. Bleeding and coagulation time were within normal limits in all cases before and after operation.
5) Bone marrow findings showed erythroid hyperplasin, and active myeloid and megakaryocytic series.
6) Liver function tests, including serum protein, thymol turbidity, alkaline phosphatase, prothrombin time and cholesterol, showed no remarkable change pre-and post-operatively.
7) Esophageal varices were detected in 17 cases (50%) among 34 investigations by means of barium meal. Splenoportography disclosed the presence of esophageal varices in additional 10 cases. Postoperatively, the esophageal varices disappeared or decreased considerably.
Spleno-protography was performed in 31 cases, and its value as diagnostic and pre-operative procedure is appreciated very highly.

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