照射脾脏治疗小儿难治性原发血小板减少性紫癜(附15例临床报告)

Splenic radiation for rafractory idiopathic thrombocytopenic purpura

目的:探讨脾脏放射治疗小儿难治性原发血小板减少性紫癜(RITP)的临床应用价值。方法:采用直线加速器的高能X线对患者脾脏进行放射治疗,放疗前后观察外周血血小板的数量,临床症状及体征。统计学采用配对计量资料t检验。结果:放疗后血小板数量较放疗前显著增加(P<0.001),临床症状及体征明显好转。放疗结束2月后临床评价,有效率86.7%。1年后复查,有效率66.7%。3年后随诊,有效率60%。未发现与放射治疗有关的并发症。结论:采用脾脏照射是治疗小儿难治性原发性血小板减少性紫癜安全有效的方法,且可避免脾脏切除。

Objective:To study the cl inical significance of splenic radiation in treatment of paediatric rafratory i diopathic thrombocytopenic purpura(RITP).Methods:Fifteen children of RITP wh o had failed of medicine therapy were accepted for splenic radiation.Pre and po st-treatment,the number of peripheral blood platelet was accounted and clinica l manifestating were recorded.Results:After splenic radiation,the peripheral blood platelet counts increased significantly (P<0.001).Two months lat er,the total effective rate was86.7%.One year later,66.7%.Three ye ars later,60%.Complications were not found.Conclusion:Splenic radiation i s a safe and effective method to raise the paletlet count in child patients wit h ITP that is refractory to medicine,and it can also avoid un-necessary splene ctomy.