腹腔镜脾切除术治疗特发性血小板减少性紫癜的临床经验

Laparoscopic splenectomy for idiopathic thrombocytopenic purpura

目的探讨腹腔镜脾切除术治疗特发性血小板减少性紫癜（idioathic thrombocytopenic purpura，ITP）的可行性及临床疗效。方法对2003年8月至2006年12月间17例ITP病例行腹腔镜脾切除术的临床资料进行回顾性分析。结果17例患者均顺利完成腹腔镜下脾切除术，无中转开腹。手术失血少，术后无出血、无消化道瘘及腹腔感染。术后血小板均有明显上升，停用激素药后1个月复查，除2例（2／17，11．8％）部分有效外，其余15例（15／17，88．2％）为完全缓解。随访3—43个月，无复发病例。结论腹腔镜脾切除术安全可行，效果良好。

Objective To investigate the feasibility and effectiveness of laparoscopic splenectomy （LS） in patients with idiopathic thrombocytopenic purpura （ITP）. Methods Clinical data of 17 ITP cases undergoing LS between Augest 2003 and December 2006 were analyzed retrospectively. Results LS was successfully conducted in all 17 cases without converting to open surgery with an average intraoperative blood loss of 120 ml in each case. There was no postoperative bleeding, fistula and infection. The platelet count increased rapidly in one week. After stopping glucocorticoid treatment for one month, 15 cases achieved complete response （88.2%） and 2 cases had partial response （11.8%）. Follow-up of 3 -43 months found no recurrence. Conclusions Use of LS for ITP is safe, feasible and effective.