特发性血小板减少性紫癜脾切除后远期疗效判断

The determination of long-term effect of idiopathic thrombocytopenic purpura after splenectomy.

目的 探讨特发性血小板减少性紫癜(ITP) 脾切除后远期疗效的判断指标。方法 远期随访1980 年5 月至1995 年11 月脾切除治疗ITP106 例。结果 具下述指标的病人远期疗效较好:①年龄≤14 岁。②术后一周内血小板达100 ×109/L。③术后血小板峰值达200 ×109/L。④脾脏重量为平均值的2 倍左右。⑤脾脏淋巴滤泡平均直径500μm 。⑥生发中心平均直径200μm 。结论 上述指标均可在脾切除后1 ～2 周获得,综合这些指标,对远期疗效可作一判断。

Objective To probe the determinative indications of long-term effect on ITP after splenectomy.Methods 106 cases of ITP treated by splenectomy during May 1980 to Nov 1995 were followed up.Results The following indications had good effect :(1)age≤14;(2)platelet counts reached 100×10 9/L during the first week after operation;(3)the peak platelet counts reached 200×10 9/L after splenectomy;(4)the spleen is twice the weight of average;(5)the mean diameter of splenic follicles greater than 500μm;(6)the average diameter of germinal centers greater than 200μm.Conclusion All the above indications can be obtained in 1～2 weeks after splenectomy.By synthesizing these indications,we can make the determination of long term effect.