重新认识脾切除术在成人原发性血小板减少性紫癜中的应用

Rediscovering splenectomy in the application of the adult idiopathic thrombocytopenic purpura

在传统治疗方式中,脾切除术是原发性血小板减少性紫癜的二线治疗方式,一般是在应用糖皮质激素药物治疗效果不佳后的选择,但临床在术前从未评价过脾切除术对于患者的疗效,未评估是否有实施脾切除术的必要性.本文将结合国内外文献,对脾切除的传统应用、不良反应、新药的代替治疗及手术效果的预测因素进行分析,以期待在治疗原发性血小板减少性紫癜时能做到精准脾切除术.

Traditionally,splenectomy is the second-line treatment method of primary thrombocytopenic purpura and a choice after the ineffectual treatment of glucocorticoid,but doctors never evaluate the curative effect of splenectomy before the operation and assess the necessity of splenectomy.In light of recent progresses on this topic,the current review summaries and pinpoints traditional application of splenectomy,side effects,new drug,and predicted factors of evaluation of operation,aiming to make accurate splenectomy for idiopathic thrombocytopenic purpura.