Roy G, Fortin C L, Leblond P F
Can J Surg. 1985 Mar;28(2):160-2.
The authors analysed retrospectively the files of 40 patients who underwent splenectomy for idiopathic thrombocytopenic purpura and who were totally or partially (relapse) resistant to a therapeutic trial of corticosteroids. There was no operative mortality but morbidity, especially respiratory, was substantial, being 40%. Drainage of the splenic bed should be avoided because this is clearly associated with a greater frequency of pulmonary complications. In 37 patients with a mean follow-up of 30.3 months, there was complete remission in 89.2% after splenectomy. This confirms the therapeutic value of splenectomy in idiopathic thrombocytopenic purpura, especially in those who showed a partial (transitory) response to corticosteroids.
作者回顾性分析了40例因特发性血小板减少性紫癜接受脾切除术且对皮质类固醇治疗试验完全或部分(复发)耐药的患者病历。无手术死亡,但发病率很高,尤其是呼吸系统疾病,达40%。应避免脾床引流,因为这显然与肺部并发症的发生率较高有关。在37例平均随访30.3个月的患者中,脾切除术后89.2%完全缓解。这证实了脾切除术在特发性血小板减少性紫癜中的治疗价值,尤其是在那些对皮质类固醇有部分(短暂)反应的患者中。