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目的:探讨脾切除对难治性特发性血小板减少性紫癜的治疗效果及影响因素。方法:回顾15年中行脾切除术治疗难治性ITP患者62例的临床资料,分析年龄、性别、术前有无出血、术前对激素的反应、脾脏是否肿大、术后血小板峰值与脾切除疗效之间的关系。结果:62例中,显效34例,良效13例,进步10例,无效5例;有效率(显效+良效)为75.8%。性别和脾脏是否肿大与脾切除术疗效无关(均P>0.05);有无出血症状、年龄、术后血小板峰值、骨髓巨核细胞数等因素分组间差异具有统计学意义(均P<0.05);多因素分析表明,术前对激素的反应及术前血小板计数对脾切除疗效是主要的影响因素(均P<0.05)。结论:术前对激素的反应及术前血小板计数可作为脾切除术的疗效预测指标。
Objective: To investigate the therapeutic effect and influencing factors of splenectomy on refractory idiopathic thrombocytopenic purpura. Methods: The clinical data of 62 cases of refractory ITP treated with splenectomy in 15 years were retrospectively analyzed. The age, gender, preoperative and without hemorrhage, preoperative hormonal response, splenomegaly, postoperative platelet peak and spleen Relationship between resection and curative effect. Results: In 62 cases, 34 cases were markedly effective, 13 cases were good, 10 cases were improved and 5 cases were ineffective. The effective rate (effective rate) was 75.8%. (P> 0.05); There were no significant differences in the incidence of bleeding, age, postoperative platelet count, number of bone marrow megakaryocytes and other factors between groups (all P <0.05) Multivariate analysis showed that preoperative hormone response and preoperative platelet count were the main influencing factors for splenectomy (all P <0.05). Conclusion: The preoperative hormone response and preoperative platelet count can be used as predictors of efficacy of splenectomy.