脾切除治疗原发性血小板减少性紫癜的疗效观察

Clinical Observation of Splenectomy on Chronic Idiopathic Thrombocytopenic Purpura

目的 观察脾切除对原发性血小板减少性紫癜 (ITP)的治疗效果。方法 对我院 1990～ 1999年内科治疗无效的 7例ITP患者行脾切除手术 ,并对其临床疗效进行观察。全组患者术后随访 6个月至 8年。结果 7例患者术前血小板计数平均为 3 2× 10 9 L ,术后第 3天、7天、1个月、2个月及半年血小板平均值分别上升为 191× 10 9 L、3 5 4× 10 9 L、3 17× 10 9 L、2 0 0× 10 9 L和 15 1× 10 9 L ,本组患者血小板均于术后 1周内恢复正常 (≥10 0× 10 9 L) ;术后半年血小板在正常范围者 6例 ,治愈 6 7,显效 1例。术后各阶段血小板计数与术前的差异均有显著性意义。结论 术前病程长短与手术疗效无相关关系 ,脾切除治疗ITP有效。

Objective To study the results of splenectomy in patients with idiopathic thrombocytopenic purpura. Methods Seven patients who failed to respond to conservative management were treated with splenectomy and followed up for 6 months to 8 years (1990～1999).Results The pre splenectomy patients had symptoms of bleeding and their platelet count on average was 32×10 9/L. The 3th,7th day and 1th,2th, 6th month after splenectomy, the average platelet count was 191×10 9/L,354×10 9/L,317×10 9/L,200×10 9/L and 151×10 9/L respectively. Their platelet recovered to normal during a week in 7 cases (≥100×10 9/L); In 6 patients the platelet count was normal in the 6th month after splenectomy, the success rate was 6/7, the rate of remission was 1/6. The platelet count after splenectomy was significantly higher than that before splenectomy.Conclusion There are no correlation between the course of disease before splenectomy and the results of splenectomy. Splenectomy is safe and effective in the treatment of idiopathic thrombocytopenic purpura.