脾切除治疗特发性血小板减少性紫癜疗效及影响因素分析

Analysis of efficacy and influence factors of splenectomy for idiopathic thrombocytopenic purpura

目的 探讨特发性血小板减少性紫癜（idiopathic thromb-ocytopenic purpura,ITP）行脾切除治疗的效果并分析影响疗效的因素.方法 81例ITP行脾切除治疗,对其年龄、性别、术前对激素的反应、病程、术后血小板数量变化与脾切除疗效进行统计学分析.结果 81例中显效41例,良效27例,进步9例,无效4例,有效率（显效＋良效）为84％.统计学分析显示术前对激素有反应者和术后血小板峰值较高者治疗效果较好（P＜0.05）,其余各项指标差异均无统计学意义.结论 脾切除术对难治性的ITP患者安全有效,术前患者对激素治疗敏感程度可能对其手术效果的预判及指导临床治疗有一定的价值.

Objective To assess the efficacy and influence factors of splenectomy for refractory idiopathic thrombocytopenic purpura（ITP）.Methods A total of 81 patients with ITP received splenectomy.Age,gender,preoperative hormonal response,disease progress and changes in the platelet count after splenectomy were reviewed for statistical analysis.Results In all 81 cases,41 cases had excellent responses,27 cases had effective responses,9 cases made progress and 4 cases had no responses.The total effective rate was 84％.Compared with other indicators,the patients with preoperative hormonal response and high peak value of platelet after splenectomy were more likely to get a better therapeutic effect（P ＜ 0.05）.Conclusion Splenectomy is a safe and effective management for the ITP patients.Preoperative hormonal response is valuable in predicting the effectiveness of splenectomy and guiding clinical treatment for ITP.