Hypersplenism

　　1. Congestive splenomegaly caused by portal hypertension, portal hypertension is also a clinical syndrome, which often secondary to various causes of liver cirrhosis, viral hepatitis, alcoholic liver injury, liver fluke or schistosomiasis, autoimmune hepatitis, Budd-Chiari syndrome, portal vein thrombosis, or cavernous angioma, etc. are relatively common causes.

　　2. Chronic hemolytic diseases such as hereditary spherocytosis, autoimmune hemolytic anemia, and thalassemia, etc.;

　　3. Splenomegaly associated with various infections, acute infections are commonly seen in viral hepatitis or infectious mononucleosis, while chronic infections are more common in tuberculosis, brucellosis, malaria, schistosomiasis, and liver fluke disease, etc.;

　　4. Various immune system diseases, inflammatory granulomas, such as systemic lupus erythematosus, rheumatoid arthritis, Felty's syndrome, and sarcoidosis, etc.;

　　5. Malignant tumors such as lymphoma, leukemia, and metastatic spleen tumors, etc.;

　　6. Hereditary lipid storage diseases, such as Gaucher's disease and Niemann-Pick disease;

　　7. Myeloproliferative diseases such as polycythemia vera, chronic myelocytic leukemia, and myelofibrosis, etc.

　　1. Spleen embolism: partial or complete obstruction of the splenic vein due to thrombosis within the splenic vein or external compression of the splenic vein. There is a close relationship between splenic vein thrombosis and chronic pancreatitis, with approximately 45% to 65% of pancreatitis cases leading to the onset of the disease. About 21% to 35% are commonly associated with tumor compression. Non-cirrhotic portal hypertension is the main pathological and physiological change in this disease. The three main characteristics of non-cirrhotic portal hypertension are: a good liver, a bad splenic vein, and ruptured esophageal varices. This disease is more common in middle-aged people (especially those aged 45 to 50), with a higher incidence in males.

　　2. Perisplenic inflammation, as well as severe pain in the upper left abdomen or lower left chest, which worsens with respiration, local tenderness and friction, and can be heard friction sounds.

　　3. Complications with various infections, mainly due to decreased white blood cell count.

　　4. Significant splenic enlargement causes obvious compression symptoms;

　　5. Anemia: Refers to a common clinical symptom where the volume of red blood cells in peripheral blood of the human body is reduced, below the lower limit of the normal range. Due to the complexity of red blood cell volume measurement, hemoglobin (Hb) concentration is often used in clinical practice. Chinese hematologists believe that in the areas at sea level in China, the Hb concentration of adult males

　　6. Hemorrhagic symptoms: The disease is divided into three types: early onset, classic, and late onset, also known as late onset.

　　7. Recurrent feelings

　　The main hazards of splenic hyperfunction are in two aspects. Firstly, the displacement effect caused by splenomegaly can cause a certain degree of discomfort, mainly manifested as abdominal distension and a feeling of fullness after eating. However, patients often tolerate this, and in clinical practice, patients with

　　The main impact on the body is related to the function of the spleen. When blood passes through the spleen, blood cells are excessively damaged, leading to a decrease in the count of red blood cells, white blood cells, and platelets, accompanied by a series of symptoms. In short, a decrease in granulocytes can easily lead to infection, a decrease in red blood cells indicates anemia, which is manifested as pale complexion and weakness, and a decrease in platelets is prone to bleeding.

　　In cases of splenic hyperfunction, if accompanied by bone marrow suppression, hematopoietic function may be enhanced, and immune and secretory functions may also be affected. However, due to the decrease in blood cell count, it is often overlooked.

　　Considering the diversity and complexity of the primary disease, prevention is almost impossible. Given that China is a high incidence area for viral hepatitis, preventing the spread of hepatitis and active antiviral treatment still have significance.

　　Actively prevent liver cirrhosis caused by various etiologies, especially schistosomal cirrhosis. Chronic infections such as malaria, tuberculosis, malignant tumors such as lymphoma, chronic lymphocytic leukemia, myelofibrosis, and chronic hemolytic anemia, as well as rare reticuloendothelial cell diseases.

　　Early detection, early treatment, and active prevention of further aggravation are crucial for the etiology and progression of liver cirrhosis.

　　Maintain a regular lifestyle, quit smoking and drinking, and avoid taking drugs that are harmful to the liver. Regularly taking antiviral drugs for hepatitis B to suppress the activity of the hepatitis B virus, Chinese herbal medicine for liver protection has a certain curative effect, but it is necessary to consult a doctor in a regular hospital, choose the right medicine that is not harmful to the liver.

　　Regular checks are very important. Hepatitis B patients and carriers of hepatitis B virus should have a hepatitis B virus detection, liver function, AFP (alpha-fetoprotein, a tumor marker) quantification, and B-ultrasound examination every six months. If necessary, MRI or CT and gastroscopy should also be performed to evaluate the activity status of hepatitis B virus and the compensation status of liver function.

　　Enlargement of the spleen: almost all cases have an enlarged spleen. For those who cannot feel the spleen under the ribs, further examinations should be conducted to confirm whether it is enlarged. Scanning of the spleen area with 99mTc, 198Au, or 113mIn colloids can help estimate the size and shape of the spleen. Computed tomography can also determine the size and lesions within the spleen. However, the degree of splenomegaly does not necessarily correlate with the severity of hyperplasia of the spleen function.

　　The number of blood cells may decrease, and red blood cells, white blood cells, or platelets can decrease alone or simultaneously. Generally, only white blood cells or platelets decrease in early cases, while in late cases, all blood cells may decrease.

　　The bone marrow shows a hyperplasia of hematopoietic cells. In some cases, there may also be a mature disorder, which may also be caused by the excessive destruction of peripheral blood cells and the release of too many mature cells, causing a similar mature disorder.

　　After splenectomy, the number of blood cells can approach or return to normal unless the bone marrow hematopoietic function is damaged.

　　After radioactive nuclide scanning with 51Cr-labeled platelets or red blood cells are injected into the body, the amount of 51Cr in the spleen area found by surface scanning is more than 2-3 times greater than that in the liver, indicating that platelets or red blood cells are destroyed excessively in the spleen.

　　1, Chicken with chestnut

　　Experts state that chicken can enhance the body's hematopoietic function, and chestnuts are good for strengthening the spleen, which is beneficial for absorbing the nutritional components of chicken. It is best to stew chestnuts with chicken soup made from old hens.

　　2, Fish with tofu

　　Experts say that fish is rich in methionine and low in phenylalanine, while tofu is the opposite. When eaten together, they can complement each other's strengths. Tofu contains more calcium, which can be absorbed by the vitamin D in the fish body to improve the body's absorption rate of calcium, making it suitable for the elderly and pregnant women.

　　3, Lamb with ginger

　　Lamb can nourish the blood and warm the yang, and ginger can relieve pain and expel dampness and wind. When paired together, ginger removes the smell of lamb, helping it to exert the effect of warming the yang and dispelling cold. Lamb with yam can nourish the blood, strengthen the body, and promote defecation; when added with coriander, it can stimulate the appetite and invigorate the yang.

　　4, Beef with potato

　　Experts say that beef is rich in nutritional value, can strengthen the spleen and stomach, and eating beef in winter can also warm the stomach. However, beef fibers are coarse, which can stimulate the gastric mucosa. Adding some potatoes can protect the stomach, and potatoes are also nutritious; beef with taro can nourish the middle and invigorate the Qi, and can relieve constipation.

　　5, Pork with onion

　　Experts introduce that onions can promote fat metabolism, reduce blood viscosity, and reduce the side effects of eating pork with high fat content. Pork is a 'versatile' meat dish, and when paired with winter melon or lily, it has a laxative effect; when added with kelp, it relieves dampness and itching; when added with pumpkin, it lowers blood sugar; and when added with soybean sprouts, it promotes diuresis and reduces edema.

　　6, Duck meat with yam

　　Experts point out that old ducks can supplement human body fluids, nourish yin, relieve heat, and stop coughing. The yam has a stronger yin-nourishing effect, and when eaten with duck meat, it can eliminate greasiness and nourish the lungs.

　　1. Drug Treatment

　　For secondary splenic hyperfunction, active treatment for the primary disease is needed. For example, when the infection is controlled, leukemia is relieved, and portal hypertension is reduced, splenic hyperfunction can usually be relieved to some extent. However, for splenic enlargement that is still difficult to control after non-surgical treatment, because there is no specific drug that can inhibit it, once severe anemia, thrombocytopenia leads to serious bleeding, and so on, surgical or interventional treatment is the preferred method. Generally including splenectomy, partial splenectomy, interventional treatment (currently mainly splenic artery embolism), among which splenectomy has the most direct and definite efficacy.

　　2. Surgical Treatment

　　In addition to splenectomy for primary splenic hyperfunction and splenic diseases such as splenic tumors, splenectomy for splenic hyperfunction needs to meet strict indications. The main diseases include the following:

　　(1) Congestive splenomegaly caused by portal hypertension;

　　(2) Splenomegaly caused by infectious diseases, such as splenic abscess, tuberculosis;

　　(3) Hereditary spherocytosis, autoimmune hemolytic anemia, and others;

　　(4) Primary thrombocytopenic purpura patients who are ineffective with medical treatment;

　　(5) Chronic aplastic anemia;

　　(6) Patients with macrocytic anemia caused by chronic myelocytic leukemia;

　　(7) Gaucher's disease;

　　(8) Some Hodgkin's disease.

　　It needs to be emphasized especially that splenectomy or splenic artery embolism can only relieve the impact of the spleen on the blood system, but cannot cure the primary disease. Especially for some blood system diseases such as splenic hyperfunction in red and white blood diseases, which can alleviate the symptoms of the disease itself, the hematopoietic function of patients with chronic myelofibrosis can be transferred to the spleen when the bone marrow becomes hard, or the liver lesions of Gaucher's disease may worsen after splenectomy, and splenectomy may be more harmful than beneficial.

　　For splenic hyperfunction caused by other etiologies, the choice of treatment needs to fully refer to the professional opinions of hematology, rheumatology, and infectious diseases, make a full assessment of the impact on splenectomy, and then decide whether to perform surgical treatment.

　　3. Interventional Treatment

　　For patients suitable for splenectomy, whether their own conditions are feasible and whether there are surgical contraindications also need to be evaluated in a regular hospital specialty department. If surgical treatment cannot be tolerated, minimally invasive interventional treatment is a suitable option.