Oida Takatsugu, Kano Hisao, Mimatsu Kenji, Kawasaki Atsushi, Kuboi Youichi, Fukino Nobutada, Kida Kazutoshi, Amano Sadao
Department of Surgery, Social Insurance Yokohama Central Hospital, Yokohama, Japan.
Hepatogastroenterology. 2012 Jun;59(116):1033-5. doi: 10.5754/hge10032.
BACKGROUND/AIMS: Splenectomy is one of the main causes of reactive thrombocytosis. In most cases, thrombocytosis found incidentally is harmless and resolves spontaneously; however, extreme thrombocytosis may result in thrombotic events such as acute myocardial infarction, mesenteric vein thrombosis and pulmonary embolism. Thus, there are no clear indications for determining which patients with reactive thrombocytosis require treatment. In this study, we evaluated reactive thrombocytosis that developed after splenectomy with or without additional organ resection.
We retrospectively studied 70 patients who underwent splenectomy. These patients were divided into 2 groups: the only splenectomy group (group A) and the splenectomy with additional organ resection group (group B).
Both the platelet count at 1 week and 1 month after the operation (p<0.01 and p<0.001, respectively) and the incidence rate of thrombocytosis at 1 week and 1 month (p<0.4089 and p<0.0007, respectively) were significantly higher in group A than in group B. All patients in both groups recovered from thrombocytosis without any platelet reduction therapy and there was no postoperative thrombosis.
Splenectomy often results in reactive thrombocytosis; however, platelet reduction therapy is not required for treating postsplenectomy reactive thrombocytosis.
背景/目的：脾切除术是反应性血小板增多症的主要病因之一。在大多数情况下，偶然发现的血小板增多症并无危害且可自行缓解；然而，极端的血小板增多症可能导致血栓形成事件，如急性心肌梗死、肠系膜静脉血栓形成和肺栓塞。因此，对于哪些反应性血小板增多症患者需要治疗，尚无明确的指征。在本研究中，我们评估了脾切除术后伴或不伴额外器官切除术后发生的反应性血小板增多症。
我们回顾性研究了70例行脾切除术的患者。这些患者被分为两组：单纯脾切除术组（A组）和脾切除加额外器官切除术组（B组）。
术后1周和1个月时的血小板计数（分别为p<0.01和p<0.001）以及术后1周和1个月时血小板增多症的发生率（分别为p<0.4089和p<0.0007），A组均显著高于B组。两组所有患者均未接受任何血小板减少治疗即从血小板增多症中恢复，且无术后血栓形成。
脾切除术常导致反应性血小板增多症；然而，治疗脾切除术后反应性血小板增多症无需进行血小板减少治疗。
