腹腔镜脾切除术治疗难治性免疫性血小板减少症疗效观察  

The clinical observation of laparoscopic splenectomy for refractory idiopathic thrombocytopenic purpura

作　　者：李永利[1] 王涛[1] 朱立峰[1] 

机构地区：[1]宝鸡市中心医院肝胆胰脾外科,陕西宝鸡721008

出　　处：《肝胆胰外科杂志》2015年第3期187-189,共3页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的分析腹腔镜脾切除术(LS)治疗成人难治性免疫性血小板减少症(ITP)的疗效。方法对2010年3月至2012年5月我科收治的难治性ITP患者共47例临床资料进行分析。结果 46例顺利完成LS,1例因脾蒂出血中转开腹,随访24个月。完全反应(CR)30例、部分反应(PR)8例、无反应(NR)9例,总体有效率80.8%。血小板计数(BPC)峰值时间出现在术后第7天左右,术后2个月时血小板数目基本稳定,CR组、PR组与NR组的血小板数目以及年龄均有统计学差异(P<0.05)。结论腹腔镜脾切除安全有效,患者年龄是影响预后的因素,手术时间、术中出血与疗效无关,术后第7天BPC数目可反映预后,术后2个月BPC数目与2年后一致。Objective To assess the effect of laparoscopic splenectomy on the patients with refractory idiopathic thrombocytopenic purpura （ITP）. Methods Forty-seven cases of ITP who underwent splenectomy between Mar. 2010 and May. 2012 were retrospectively analyzed. Results Except for 1 case converted to open surgery because of splenic pedicle hemorrhage, 46 patients received laparoscopic splenectomy successfully. During follow-up period （24 months）, 30 cases had complete response （CR）, 8 cases had partial response （PR）, 9 cases had no response （NR）. The peak of platelet counts appeared on day 7 postopertativly. The platelet count was stable in 2 months postopertativly. There were statistical significance in platelet counts and age between excellent group （CR and PR） and NR group （P〈0.05）. Conclusion Laparoscopic splenectomy is a safe and effective treatment method, patient age is the factor of prognosis. Operation duration and intrapoerative blood loss were irrelevant to treatment effect. Platelet counts on day 7 postoperativly may predict the prognosis of laparoscopic splenectomy. Platelet counts in 2 months postoperativly coincide with those at 2-year follow-up.

关 键 词：免疫性血小板减少症 腹腔镜脾切除 血小板数目 

分 类 号：R657.6[医药卫生—外科学]