不同面积脾栓塞治疗特发性血小板减少性紫癜及其对脾功能的影响

Partial splenic embolization for idiopathic thrombocytopenic purpura:therapeutic effect and influence of the embolization on splenic function

目的 探讨不同面积的脾栓塞治疗特发性血小板减少性紫癜ITP的效果及其对脾功能的影响。方法 将45例特发性血小板减少性紫癜患者随机分为2组，进行脾栓塞治疗。治疗组(A组)栓塞面积为60％～80％；对照组(B)组栓塞面积为40％～60%。结果 两组患者术后1周内血小板均明显升高；但1年后A组血小板平均值明显高于B组(P<0．01)。治疗前后两组内患者脾功能均无明显变化(P>0．05)。结论 大面积脾栓塞治疗ITP与小面积脾栓塞近期疗效相似，但前者疗效更持久、安全．不影响脾功能．值得推广。

Objective To explore the therapeutic effect of partial splenic embolization of different embolized volumes for idiopathic thrombocytopenic purpura (ITP) and consequent changes of the splenic function. Methods Forty-five ITP patients were randomized into 2 groups to receive splenic embolization with gelatin sponge particles, and the embolized volume ranged between 60% and 80% in the former group (group A), and between 40% and 60% in the latter group (group B). Results The platelet counts of the patients in both groups markedly increased one week after the operation, and the average count was significant higher in group A than in group B one year after the operation (P<0.01). The splenic function of the patients in neither of groups underwent any significant changes after the operation (P>0.05). Conclusion Splenic embolization of different volumes produces similar therapeutic effect on ITP, but more extensive embolization may insure long-lasting effect with better safety and less influence on splenic function.