Hyperplastic spleen syndrome

　　Hyperplastic spleen syndrome can be divided into primary and secondary types. The primary hyperplastic spleen without known etiology. Secondary hyperplastic spleen can be seen in patients with splenomegaly with relatively clear etiology, such as liver cirrhosis caused by various etiologies (especially schistosomiasis 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 disease.

　　With the development of the disease, common complications of hyperplastic spleen syndrome include:

　　1. Significant splenic enlargement causing obvious compression symptoms;

　　2. Anemia;

　　3. Hemorrhagic symptoms;

　　4. Recurrent sensation.

　　The symptoms of patients with hyperplastic spleen syndrome vary in severity. When the condition is mild, there may be no symptoms. Secondary hyperplastic spleen syndrome is often accompanied by symptoms of the primary disease, and even may mask the symptoms of hyperplastic spleen itself. Patients usually have decreased resistance, pale complexion, dizziness, palpitations, infection, fever, and when thrombocytopenia occurs, there is a tendency to bleed. Physical examination shows that the spleen can be slightly, moderately, or severely enlarged.

　　Hyperplastic spleen syndrome can be divided into primary and secondary types. To prevent the occurrence of the disease, it is first necessary to avoid the primary factors that can lead to hyperplastic spleen, actively treat the primary diseases that cause hyperplastic spleen, and in daily life, pay attention to forming good living habits, actively exercising the body, and fundamentally reducing the possibility of disease occurrence.

　　Patients with hyperplastic spleen syndrome show a systemic comprehensive symptom, and it is usually necessary to confirm the diagnosis of the disease through the following examination methods:

　　1. Ultrasound examination:Almost all cases have splenomegaly, but the degree of splenomegaly is not necessarily proportional to the degree of hypersplenism.

　　2. Peripheral blood examination:Red blood cells, white blood cells, or platelets in peripheral blood can decrease alone or simultaneously, generally in early cases, only white blood cells or platelets decrease, and in late cases, there may be a decrease in all blood cells, and the decrease in blood cells is not proportional to the splenomegaly.

　　3. Bone marrow biopsy:The bone marrow shows a hyperplasia of hematopoietic cells, and in some cases, there may also be maturation disorders, which may also be caused by the excessive destruction of peripheral blood cells, the release of mature cells in excess, causing a similar maturation disorder.

　　4. Radioisotope scanning:After 51Cr-labeled platelets or red blood cells are injected into the body and scanned on the surface, it is found that the 51Cr amount in the spleen area is 2-3 times greater than that in the liver, indicating that platelets or red blood cells are excessively destroyed in the spleen.

　　5. Changes after splenectomy:Generally, after splenectomy, the blood cell count can approach or return to normal, unless the bone marrow hematopoietic function is damaged.

　　There are no special dietary requirements for patients with hypersplenism, and general normal diet is sufficient. Pay attention to a rich diet, balanced nutrition, and meet the needs of heat, protein, and vitamins required for normal human metabolism. Increase the intake of vegetables and fruits appropriately. In terms of health care, pay attention to relaxing the mind, building confidence, maintaining a good attitude, and actively cooperating with the doctor's treatment.

　　Splenectomy and X-ray radiotherapy cannot relieve the primary disease causing hypersplenism, so it is generally advisable to treat the primary disease first, and if it does not yield results, then actively treat the primary disease after splenectomy. The indications for splenectomy include the following points:

　　1. Marked splenomegaly, causing significant compressive symptoms.

　　2. Severe anemia, especially hemolytic anemia.

　　3. There is a significant degree of thrombocytopenia and bleeding symptoms. If the platelet count is normal or slightly reduced, thrombocytosis may occur after splenectomy, and even thrombosis may occur, so it is not advisable to remove the spleen for those with normal or slightly reduced platelets.

　　Before the operation for hypersplenism, sufficient preparation should be made, such as blood transfusion for severe anemia, adrenal cortical hormone treatment for those with thrombocytopenia and bleeding, and active prevention of infection for those with granulocytopenia.