【摘要】 目的探讨脾切除对内科治疗无效的特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)的治疗效果。方法对2000年5月～2008年4月经内科治疗无效在我科行脾切除术的69例ITP(其中6例附加副脾摘除术)的年龄、性别、术前病程、术前对激素的反应、术后血小板峰值与脾切除疗效进行统计学分析。结果全部69例中,显效36例,良效18例,进步10例,无效5例,有效率(显效+良效)为78.3%。随访1年以上者57例,其中复发6例,复发率为10.5%。统计学分析显示术前对激素有反应者和术后血小板峰值较高者治疗效果较好(P<0.01),其余各项均无显著性差异。结论脾切除术对内科治疗无效的难治性ITP病人是一种安全有效的治疗方法。更多还原

【Abstract】 Objective To assess the long-term efficacy of splenectomy for patients with idiopathic thrombocytopenic purpura(ITP)who failed to conservative treatment.Methods Sixty-nine cases with ITP who failed to conservative treatment were treated with splenectomy from May 2000 to April 2008,and at the same period,6 cases out of them were treated with accessory spleen extirpation.The relation of the efficacy of splenectomy with age,sex,disease duration,previous response to steroids and the peak of postoperative platelet counts was analyzed statistically.Results Among 69 ITP patients,36 cases had complete response,18 cases partial response,10 cases improvement and 5 cases were ineffective.The total effective rate was 78.3%.Fifty-seven patients were followed up for over 1 year,and 6 cases had recurrence with the recurrence being 10.5%.The statistical analysis revealed that patients who showed temporary response to preoperative steroid therapy and those who had a high peak of postoperative platelet counts had better efficacy(P<0.01).No significant difference was found in the rest indexes.Conclusion Splenectomy is a safe and effective management for the patients with ITP who failed to conservative methods.更多还原