脾腫の臨床的並びに統計的観察
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Clinical and statistical studies were carried out on the patients hospitalized in our clinic in the past 20 years who had splenomegaly. Some patients with Banti's syndrome or congenital hemolytic anemia who had splenomegaly were further studied hematologically after they had been splenectomized. 1. Among 8,280 patients who had been hospitalized in our clinic during the period under review, there were 433 patients (5.22%) who developed splenomegaly. Its incidence for the first 10 years was 5.75%. Most of the patients who were found to have splenomegaly were suffering from one associated with an infection. Its incidence for the last 10 years was 4.63 %. The patients were mostly afflicted with splenomegaly of chronic form. 2. In the patients with polycythemia vera who had splenomegaly, there was a tendency to an excess in the amount of red corpuscles in the blood. The patients with some other disease than acute infectious diseases and cardiac disorder who had splenomegaly, however, almost always had anemia of varying degree, of severity. 3. The patients with leukemia, a disease of tubercular origin, or polycythemia vera who had splenomegaly, were marked by an increase in the number of leukocytes in the blood. The majority of other patients with splenomegaly had leukopenia of varying degrees of severity, and some of them were thrombopenic. 4. The patients in whom the enlarged spleen palpable below the lowest rib was smaller than the breadth of two cross fingers, generally tended to improve and be cured with medical treatment. When the enlarged spleen palpable below the lowest rib was larger than the breadth of three cross fingers, medical treatment seldom resulted in an improvement in hepatomegaly, splenomegaly and leukocyte count, if there was an improvement in general conditions. 5. Of the patients with splenomegaly in whom the enlarged spleen was larger than the breadth of three cross fingers, many of those who had leukemia, Banti's syndrome or hemolytic anemia gave normal serum Takada reaction and erythrocyte sedimentation rate. 6. When splenectomized, the patients with Banti's syndrome or congenital hemolytic anemia showed an improvement in general conditions, the numbers of blood cells in the peripheral blood, serum iron levels, life span of the red corpuscles and bone marrow findings. In 3 to 6 months following splenectomy, peripheral blood picture showed a complete reversal of the percentages of the neutrophils and lymphocytes, the former showing an decrease and the latter a increase. Bone marrow picture also showed an increased percentage of the lymphocytes. This seems to indicate that the function of the spleen affects not only the bone marrow but also the lymphogenous tissues.
- 千葉大学の論文
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- 脾腫の臨床的並びに統計的観察