重度难治性原发性血小板减少性紫癜脾切除的疗效观察

The Effect of Splenectomy in Treatment of Patients with Severe Refractory Idiopathy Thromboeytopenic Purpura

报道２４例重度难治性原发性血小板减少性紫癜（ＳＲ－ＩＴＰ）患者脾切除疗效，术后１个月内全部患者临床出血症状迅速好转，２２例血小板达１００×１０９／Ｌ以上，近期疗效临床缓解１７例，缓解串７０．８％，显效４例（１６．７％）总有效率８７．５％，远期随访总有效率８６．３％，复发率９％。结果提示，脾切除治疗ＳＲ－ＩＴＰ是较为有效而安全的治疗措施。

4 patients with severe refractory idiopathy thrombocytopenic purpura(SR-ITP)been treated bysplenectomy. Bleeding symptoms of 24 cases had been improved, 22 patient's platelet counts achiered above100 ×109//L,Only 2 patient's platelet counts under 50×109/L,Within l month after splenectmy,Late ef-fect (within 2 months after splenectomy).platelet counts mointainqcl above 100×109/L in 17 cases,4patient's platelet counts improved to 50-100×109/L(16.7%).total respinsive rate was 87.5%,Long termeffect C follow up at least 1-10 year,demonstrafed that total reaponsive rate was 86.3%.2/22 casesreaped(9%).The therapentic effect of splenectomy in patients with SR-ITP is not related with response of prednison be-fore splenectiny with risimg rate of platelet after splenectomy.It suggest that the splenectomy is valuable and saftey in treatment of patients with SR-ITP.