脾切除治疗特发性血小板减少性紫癜的疗效观察

Effect of splenectomy on idiopathic thrombocytopenic purpura

目的观察脾切除治疗特发性血小板减少性紫癜（ITP）患者的疗效。方法对9例ITP患者在皮质激素治疗效果不佳、有皮质激素治疗禁忌、不能耐受皮质激素治疗或其他自身原因拒绝接受皮质激素治疗的情况下采用脾切除治疗。结果术后第1、4、7天血小板平均值由术前的35×10^9／L分别上升为98×10^9／L、179×10^9和235×10^9／L；术后随访半年以上，显效7例，总有效率88．9％。结论脾切除治疗仍是ITP患者值得推荐的一种方法，尤其是药物治疗无效、有禁忌或不能耐受药物治疗的患者。

Objective To investigate the effects of splenctomy on the idiopathic thrombocytopenic purpura （ITP） patients. Methods 9 patients with ITP were involved in the present study,who were performed with splenectomy because of refractoriness, contraindication and intolerance during eorticosteroids therapy. Results The average platelet count of the patients before operation was 35×10^9/L, while the first ,4th and 7th day after operation, the average platelet count was 98×10^9/L, 179×10^9 and 235×10^9/L. After follow-up for 6 months, there were 7 eases having marked improvement, and the total effective rate was 88.9%. Conclusion Spleneetomy is a recommendable method for ITP,expecially for those are inefficient,incompatible and intolerated to continually pharmacotherapy.