腹腔镜脾切除术治疗特发性血小板减少性紫癜的疗效观察

Effects of Laparoscopic Splenectomy on 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（idiopathic thrombocytopenic purpura，ITP）的可行性及临床疗效。方法对2005年6月～2010年9月30例行腹腔镜脾切除术的ITP患者病例资料进行回顾性分析。结果30例均成功完成腹腔镜下脾切除术，手术时间110～260 min，平均140 min，术中失血40～400 mL，平均150 mL，无中转开腹，术后无出血、消化道瘘及感染。血小板计数较术前明显升高，24例（80.0%）完全缓解，2例（6.7%）为部分缓解，4例（13.3%）不缓解。结论腹腔镜脾切除术是治疗ITP的有效方法，具有创伤小、恢复快和并发症发生率低等优点。

Objective To investigate the feasibility and effectiveness of laparoscopic splenectomy （LS） in pa-tients with idiopathic thrombocytopenic purpura （ITP）. Methods Clinical data of 30 cases undergoing LS between June 2005 and September 2010 were analyzed retrospectively. Results LS were successfully conducted in all 30 cases without converting to open surgery with an operation time of 110～260 min （mean, 140 min） and estimated intraoperative blood loss of 40～400 mL （mean, 150 mL）. There was no postoperative bleeding, ifstula and infec-tion. The platelet count increased rapidly. 24 cases （80.0%） achieved complete response, 2 cases （6.7%） had par-tial response and 4 cases （13.3%） had no response. Conclusion Use of laparoscopic splenectomy for ITP is safe, feasible and effective. LS is therapeutically useful method and also have minimal invasion, quicker recovery and less complications.