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术前第1天的血小板计数可预测中国难治性特发性血小板减少性紫癜患者接受腹腔镜脾切除术后的长期反应。

Platelet count on preoperative day 1 predicts the long-term responses to laparoscopic splenectomy for Chinese patients with medically refractory idiopathic thrombocytopenic purpura.

作者信息

Liao Rui, Tang Pei-Yuan, Song Jun-Feng, Qin Ke-Le, Wang Xun, Yan Xiong

机构信息

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Chongqing, 400016, China.

出版信息

BMC Surg. 2018 Nov 26;18(1):108. doi: 10.1186/s12893-018-0446-8.

Abstract

BACKGROUND

Laparoscopic splenectomy (LS) is regarded as a second-line treatment for medically refractory idiopathic thrombocytopenic purpura (ITP), but the predictive factors for the long-term postoperative responses to ITP are still a matter of debate. We aimed to investigate the factors that can predict the long-term response after LS for Chinese patients with medically refractory ITP.

METHODS

From January 2011 to September 2016, 78 Chinese patients with ITP who underwent LS were retrospectively analyzed. Twelve parameters were analyzed by univariate and multivariate methods.

RESULTS

Univariate analysis revealed that platelet count on preoperative day (PRD) 1 (P < 0.001) and operative time (P = 0.011) were significantly associated with long-term response of ITP after LS. Multivariate analysis revealed that platelet count on PRD 1 was a predictive factor of long-term response (P < 0.001). Furthermore, a long-term, stable response of platelet count on PRD 1 of > 30.0 × 10/L was easier to achieve than a platelet count on PRD 1 ≤ 30.0 × 10/L after LS for ITP.

CONCLUSIONS

LS is a valuable and effective option in the treatment of medically refractory ITP. Platelet count on PRD 1 is an independent predicting factor for long-term response after LS for Chinese patients with ITP.

摘要

背景

腹腔镜脾切除术(LS)被视为药物难治性特发性血小板减少性紫癜(ITP)的二线治疗方法,但术后ITP长期反应的预测因素仍存在争议。我们旨在研究可预测中国药物难治性ITP患者LS术后长期反应的因素。

方法

回顾性分析2011年1月至2016年9月期间接受LS的78例中国ITP患者。采用单因素和多因素方法分析12项参数。

结果

单因素分析显示,术前第1天(PRD 1)的血小板计数(P < 0.001)和手术时间(P = 0.011)与LS术后ITP的长期反应显著相关。多因素分析显示,PRD 1的血小板计数是长期反应的预测因素(P < 0.001)。此外,对于ITP患者,LS术后PRD 1血小板计数>30.0×10⁹/L比PRD 1血小板计数≤30.0×10⁹/L更容易实现长期稳定反应。

结论

LS是治疗药物难治性ITP的一种有价值且有效的选择。PRD 1的血小板计数是中国ITP患者LS术后长期反应的独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ac9/6260580/660dece5f5b2/12893_2018_446_Fig1_HTML.jpg

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