免疫性血小板减少症脾切除治疗

严泽莹; 张苏江

doi:10.13201/j.issn.1004-2806.2018.01.009

免疫性血小板减少症脾切除治疗

严泽莹,
张苏江^,

- 上海交通大学医学院附属瑞金医院北院血液科(上海, 201801)

详细信息

通讯作者: 张苏江,E-mail:zbruce.zhang@hotmail.com

中图分类号: R558.2

收稿日期: 2017-05-28

Splenectomy for the treatment of immune thrombocytopenia

YAN Zeying,
ZHANG Sujiang^,

- North Hospital of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 201801, China

More Information

Corresponding author: ZHANG Sujiang, E-mail: zbruce.zhang@hotmail.com

Received Date: 28 May 2017

摘要

摘要: 目的:探讨免疫性血小板减少症(ITP)患者脾切除术后预后的影响因素。方法:回顾性分析31例行脾切除术治疗的ITP患者,统计分析患者的疗效,包括显效、良效、进步、无效,并对性别、年龄、脾脏大小、对激素治疗的反应、术前病程时长、术前血小板计数、手术方式等相关因素进行分析。结果:31例患者中,25例采用腹腔镜术式,6例采用开腹手术;中位随访时间29个月,显效21例(67.7%),良效5例(16.1%),进步3例(9.7%),无效2例(6.5%),无一例死亡。年龄≤30岁的患者显效率明显高于年龄>30岁的患者(P=0.046),术前血小板计数≥20×10⁹/L的患者显效率明显高于术前血小板计数<20×10⁹/L的患者(P=0.018)。结论:脾切除术是一种治疗ITP安全、有效的治疗方法。年龄小于30岁和术前血小板计数高于20×10⁹/L是对ITP脾切除术疗效有利的影响因素。
- 免疫性血小板减少症 /
- 脾切除术 /
- 治疗
Abstract: Objective:To explore the splenectomy for the treatment of immune thrombocytopenia (ITP).Method:A total of 31 patients with ITP received splenectomy were enrolled.The efficacy in patients was classified as marked efficacy,good efficacy,progress,ineffective,and sex,age,spleen size,the response to steroid therapy,the duration preoperative,preoperative platelet count,surgical style and other related factors were analyzed.Result:Among 31 cases of ITP,25 cases received laparoscopic splenectomy,and the other 6 cases received open surgery.The median follow-up time was 29 months,marked efficacy was seen in 21 cases (67.7%),good efficacy in 5 cases (16.1%),improvement in 3 cases (9.7%),ineffective in 2 cases (6.5%) and no patient died.The marked efficacy rate in patients younger than 30 years of age was significantly higher than that in patients older than 30 years (P=0.046).The marked efficacy rate in patients with preoperative platelet count above 20×10⁹/L was significantly higher than that in patients with preoperative platelet count below 20×10⁹/L (P=0.018).Conclusion:Splenectomy is a safe and effective treatment of ITP.Younger than 30 years of age and preoperative platelet count above 20×10⁹/L are the two favorable factors for the effect of splenectomy in ITP.
- immune thrombocytopenia /
- splenectomy /
- treatment

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