【摘要】 目的:探讨腹腔镜脾切除术治疗难治性特发性血小板减少性紫癜(ITP)的手术安全性及临床疗效。方法:回顾性分析42例难治性ITP患者行腹腔镜脾切除的临床资料。结果:42例ITP腹腔镜手术成功率95.2%,2例中转开腹,平均手术时间105min,术中失血平均40mL。全组均于术后12～24h内恢复胃肠蠕动,术后6h下床活动,平均住院时间5d。术后1周内血小板很快上升,治疗有效率95.2%。发生并发症3例,其中1例膈下积液,2例皮下气肿。38例得到随访,4例失访,3例复发,总有效率88.1%。结论:腹腔镜脾切除术治疗ITP安全可行,临床疗效显著。更多还原

【Abstract】 Objective To evaluate the safety and efficacy of laparoscopic splenectomy in the treatment of refractory idiopathic thrombocytopenic purpura(ITP).Methods Forty-two cases of refractory ITP were analyzed retrospectively to investigate the efficacy of laparoscopic splenectomy.Results 95.2% of the patients underwent laparoscopic splenectomy successfully and only two cases were converted to open procedure.The average duration of operation was 105 minutes,and the average intraoperative blood loss was 40 mL.Peristalsis of gastrointestinal tract was rehabilitated postoperatively within 12-24 hours in all cases.The mean length of hospital stay was 5 days.The platelet count increased rapidly in one week post operation.The curative effective rate of the operation was 95.2%.Complications occurred in 3 cases,one of which was subphrenic effusion,and the remaining 2 were subcutaneous emphysema.38 patients were followed but 4 were lost to followed-up.3 patients relapsed.The total response rate was 88.1%.Conclusion Laparoscopic splenectomy for ITP is safe and feasible,and achieves significant clinical effectiveness.更多还原