无原发病外伤性脾切除患者术后血小板变化的研究

Research on Platelet Change after Splenectomy only Because of Trauma Diseases

目的:探讨无原发疾病创伤性脾破裂行脾切除术后血小板计数的变化及处理措施。方法:无原发疾病创伤性脾破裂116例,脾切除术前查血小板,术后每2日连续查血小板,持续2～6周,术后血小板上升至450～500×109/L者,使用抗凝药和抗血小板药物,单独或联合应用直至血小板降至400×109/L以下停药。结果:所有病例术后均有异常的血小板计数升高,大多数在药物处理后2～6周降至400×109/L以下。无1例血栓形成或死亡。结论:无原发疾病外伤性脾切除患者均会出现不同程度血小板升高,血小板计数和血凝四项应作为常规监测指标,及时正确的抗凝治疗可避免继发血小板增多而引起血栓形成等并发症。

Objective：To discuss the change of platelet count after splenectomy and the treatment.Methods：116 cases with splenic rupture by tranma,without primarily diseases were selected ;platelet was detected before splenectomy and the detection of platelet every other day after operation kept for 2 to 6 weeks;antiplatelet drugs or/and anti coagulant drugs were applied to those patients whose platelet count increased to 450-500×10^9/L.Results：The platelet count showed abnormal increase in all patients after operation, and decreased to 400×10^9/L after drug treatment for 2 to 6 weeks in most patients;No 1 case died from the formation ofmesentery thrombus.Conclusion： The platelet count will increase after splenectomy, platelet count and hemagglutinin test should be taken as the routine data in monitoring after spleneetomy;eorrect and prompt anticoagulatiun therapy can indrease the incidence of complications including thrombocythemia and thrombogenesis.