概述

脾脏是位于左肋廓下面的器官。包括感染、肝病和一些癌症在内的很多状况均能引起脾脏肿大,脾脏肿大也被称作脾肿大。

脾脏肿大通常不会引起症状。往往会在常规体检中发现这种情况。医生通常无法感觉到成人正常大小的脾脏,但能感觉到脾脏肿大。医生很可能会要求您接受影像学检查和血液检测来帮助确定病因。

脾脏肿大的治疗侧重于引起脾脏肿大的基础疾病。虽然通过手术切除肿大的脾脏通常不是首选治疗,但有时也会被推荐。

症状

脾脏肿大可能导致:

  • 一些情况下无症状
  • 左上腹部位疼痛或有饱胀感,并可能扩散至左肩
  • 由于脾脏肿大压迫腹部,因此在未进食或仅少量进食后有饱腹感
  • 贫血
  • 疲劳
  • 频繁感染
  • 容易出血

何时就诊

如果您的左上腹部疼痛,尤其是疼痛严重或深呼吸时疼痛加剧,请去看医生。

When to see a doctor

See your doctor promptly if you have pain in your left upper belly, especially if it's severe or the pain gets worse when you take a deep breath.

病因

很多感染和疾病都可能引起脾脏肿大。脾脏肿大可能是暂时性的,需要视治疗而定。诱发因素包括:

  • 病毒感染,如单核细胞增多症
  • 细菌感染,如梅毒或心脏内膜感染(心内膜炎)
  • 寄生虫感染,如疟疾
  • 肝硬化和其他累及肝脏的疾病
  • 各种类型的溶血性贫血(一种表现为红细胞被提前破坏的病症)
  • 血癌(如白血病和骨髓增生性肿瘤)和淋巴瘤(如霍奇金病)
  • 代谢障碍,如戈谢病和尼曼-匹克病
  • 脾脏或肝脏静脉受到压迫或这些静脉里面有血凝块

脾脏的工作原理

脾脏位于腹部左侧,胃的旁边,肋廓下方。它是一个柔软的海绵状器官,执行着几项关键工作。脾脏能够:

  • 过滤并清除衰老或损伤的血细胞
  • 产生白细胞(淋巴细胞)来预防感染,并作为抵御致病生物体的第一道防线
  • 储存有助于血液凝固的红细胞和血小板

脾脏肿大会影响这些重要功能。脾脏变大后,它会过滤正常红细胞和异常红细胞,从而减少血流中的健康细胞数量。它还会捕获过多的血小板。

过多的红细胞和血小板最终会导致脾脏阻塞,影响其发挥正常功能。肿大的脾脏甚至可能导致器官自身供血不足,从而损害或破坏脾脏某些部分。

How the spleen works

Your spleen is tucked below your rib cage next to your stomach on the left side of your belly. Its size generally relates to your height, weight and sex.

This soft, spongy organ performs several critical jobs, such as:

  • Filtering out and destroying old, damaged blood cells
  • Preventing infection by producing white blood cells (lymphocytes) and acting as a first line of defense against disease-causing organisms
  • Storing red blood cells and platelets, which help your blood clot

An enlarged spleen affects each of these jobs. When it's enlarged, your spleen may not function as usual.

风险因素

任何人在任何年纪都可能患上脾脏肿大,但某些人群的患病风险较高,包括:

  • 感染单核细胞增多症等疾病的儿童和年轻人
  • 患有高歇氏病或尼曼 - 匹克病和其他几种遗传性代谢障碍(影响肝脏和脾脏)的人群
  • 在疟疾流行的地区生活或旅行的人群

并发症

脾脏肿大的潜在并发症包括:

  • 感染。脾脏肿大可能减少血流中的健康红细胞、血小板和白细胞的数量,导致更频繁的感染。也可能出现贫血和出血增加。
  • 脾破裂。脾脏是一个柔软的器官,即使是健康的脾脏也很容易受到损伤,尤其是发生车祸时。当脾脏肿大时,发生破裂的可能性更高。脾破裂可能导致危及生命的腹腔内出血。

June 23, 2022
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