腹腔镜脾切除对难治性ITP治疗的应用价值

Application Value of Iaparoscopic Splenectomy in Treatment of Idiopathic Thrombocytope-nic Purpura

目的:探讨腹腔镜脾切除术(laparoscopicsplenectomy,LS)治疗难治性特发性血小板减少性紫癜(idiopathicthrombocytopenicpur- pura,ITP)的可行性和疗效。方法:回顾性分析2002年9月-2005年7月15例难治性ITP(血小板计数<50×109／L)行LS的临床资料。采用全麻仰卧位、三孔法进行手术。结果:1例中转传统开腹手术。14例完成LS,手术时间为56-172 min,平均107 min;术中出血量30-500ml,平均102 ml。3例术中发现副脾并切除。术后1周内血小板很快上升,胃肠蠕动恢复时间为12-24 h,平均住院时间5 d。发生并发症1例(腹壁静脉刺破出血)。随访均无复发。结论:LS治疗ITP安全可行,且临床疗效显著。

Objective： To investigate the safety and efficacy of laparoscopic splenectomy（LS） in treatment of refracty idiopatic thmmbocytopenic purpura（ITP）. Methods： Fifteen patients with ITP underwent LS from 2002 to 2005. The data of preoperative and postoperative platelet counts, intraoperative blood loss, recovery time, hospital stay time and complications were analyzed retrospectively. Results： One case was shifted to open surgery. Fourteen patients successfully underwent LS. Their mean operation time was 107 minutes, and intraoperative mean blood loss was 102ml. The platelet count was elevated rapidly in one week, and peristalsis of alimentary tract was recovered in 12 to 24 hours after operation in all cases. Their mean hospitalization time was 5 days. stabbing-caused abdominal seen in one case wall bleeding was Fourteen patients were followed up, no patient relapsed. Conclusion： LS is a relatively safe and effective measure for treatment of ITP.