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目的观察脾切除对难治性原发性血小板减少性紫癜(ITP)的治疗效果。方法对安阳地区医院1995-2008年内科治疗无效的26例ITP患者行脾切除手术,并对其临床疗效进行回顾性分析及总结。结果 26例术后,血小板均明显升高接近正常或正常以上,19例随访血小板均在正常范围,7例升高后又有不同程度的下降,再应用免疫抑制剂、糖皮质激素治疗,2例血小板正常,1例血小板50×109/L左右,4例治疗无效,其中2例发现副脾,出血倾向较重。结论脾切除治疗难治性原发性血小板减少性紫癜有效,手术相关并发症少,是一种较佳的治疗方法;副脾是否切除影响疗效。
Objective To observe the therapeutic effect of splenectomy on refractory idiopathic thrombocytopenic purpura (ITP). Methods Twenty-six cases of ITP patients who were ineffective in internal medicine treatment in Anyang district hospital from 1995 to 2008 underwent splenectomy. The clinical effects were retrospectively analyzed and summarized. Results Thrombocytopenia was significantly higher in 26 cases than in normal or normal group. All the 19 cases were followed up for platelet in the normal range. Seven cases increased and then decreased to some extent. Then, immunosuppressive agents and glucocorticoid were used. Cases of normal platelets, platelet 50 × 109 / L or so, 4 cases were ineffective, of which 2 cases found spleen, bleeding tendency heavier. Conclusions Splenectomy is effective in the treatment of refractory idiopathic thrombocytopenic purpura and less complications related to operation. It is a better treatment for splenectomy. Whether the removal of the spleen affects the curative effect.