腹腔镜脾切除术治疗特发性血小板减少性紫癜62例临床分析

Laparoscopic splenectomy for idiopathic thrombocytopenic purpura:a clinical analysis of 62 cases

目的 探讨腹腔镜脾切除术（laparoscopic splenectomy,LS）治疗特发性血小板减少性紫癜（idiopathic thrombocytopenic purpura,ITP）的安全性及疗效.方法 对62例ITP患者采用腹腔镜脾切除术.结果 62例患者术前血小板（33.18±19.36）×109/L,术中发现副脾6例,手术时间（202.66±23.95）分钟,术中出血（226.45±106.93） ml,住院时间（9.44±1.71）天,住院费用（29457±2946）元.无死亡患者,术后1周血小板明显上升为（171.32±89.00）×109/L,随访3～12个月,总有效率88.7％（55/62）.结论 LS治疗ITP,安全、有效,手术费用偏高,可避免患者长期服用激素.

Objective To explore the safety and efficacy of laparoscopic splenectomy （LS）in the treatment of idiopathic thrombocytopenie purpura（ITP）. Methods The clinical data of 62 patients with ITP who successfully underwent LS treatment were retrospectively reviewed. Results In the 62 patients, accessory spleen was found in 6 patients. The operation time was （ 202.66 ± 23.95 ） min, the intraopera- tive bleeding was （226.45 ± 106.93 ） ml, the length of hospital stay was （ 9.44 ± 1.71 ） days, and the hospital expenses （29457±2946） RMB. No death was reported. One week later, the number of platelet increased from （33.18 ±19.36）× 109/L to （ 171.32±89.00） x 109/L. During the follow-up of 3 to 12 months,the total effective rate was 88.7% （55/62）. Conclusion Laparoscopic spleneetomy is safe and effective for the treatment of ITP. Despite the high surgery fees ,it can avoid the long-term use of hormone and improve the quality of life.