Beseoglu K, Germing U, Gross-Weege W
Neurochirurgie, Universitätsklinikum Düsseldorf.
Chirurg. 2005 Aug;76(8):769-76. doi: 10.1007/s00104-004-0998-2.
Idiopathic thrombocytopenic purpura (ITP) comprises approximately 8% of all haemorrhagic diseases. Typical findings are a very low platelet count which manifests as petechial bleeding. Therapy consists of medication and removal of the spleen if conservative therapy fails.
Between 1988 and 1999, 47 patients with ITP were splenectomized in our surgical department. We examine the postoperative development of platelet counts and long-term results in 33 of these patients.
After splenectomy, more then 75% of our patients had normal platelet counts. In long-term examination, 58% remained in stable condition with normal platelet counts. Retrospectively we tried to identify preoperative clinical features that could predict the long-term outcome of splenectomy in ITP but were unable to find reliable factors.
Idiopathic thrombocytopenic purpura can be treated by surgical means but should be considered only when conservative treatment has failed. The long-term outcome of splenectomy is not predictable. Reliable predictive factors have to be identified through further research.
特发性血小板减少性紫癜（ITP）约占所有出血性疾病的8%。典型表现是血小板计数极低，表现为瘀点出血。治疗方法包括药物治疗，若保守治疗失败则进行脾切除。
1988年至1999年间，我院外科对47例ITP患者实施了脾切除术。我们对其中33例患者术后血小板计数的变化及长期结果进行了研究。
脾切除术后，超过75%的患者血小板计数恢复正常。在长期随访中，58%的患者血小板计数保持正常且病情稳定。回顾性分析时，我们试图确定术前临床特征以预测ITP患者脾切除术后的长期疗效，但未找到可靠因素。
特发性血小板减少性紫癜可通过手术治疗，但仅在保守治疗失败时才应考虑。脾切除术后的长期疗效不可预测。必须通过进一步研究确定可靠的预测因素。
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