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1970～1992年收治原发性血小板减少性紫癜(ITP)52例,占同期患血液病进行脾切除的124例的41.9%。52例进行脾切除及副脾切除,术后出血症状迅速好转,血小板均有不同程度上升,最高1例可达230×10~9/L。47例远期随访平均为4年半,其中6例术后仍有鼻衂、紫癜表现,出血倾向较术前好转,术后间歇性激素治疗。2例术后骤发肾上腺危象死亡。1例术后1年半溺水死亡。38例治愈,有效率为81%。着重讨论外科围手术期处理,防止肾上腺皮质功能衰竭危象发生,自体脾移植在 ITP 病例应用。
From 1992 to 1992, 52 cases of idiopathic thrombocytopenic purpura (ITP) were admitted, accounting for 41.9% of 124 cases with splenectomy for the same period. Fifty-two patients underwent splenectomy and splenectomy. The postoperative bleeding symptoms improved rapidly and the platelets increased in varying degrees. The highest one case reached 230 × 10 ~ 9 / L. 47 cases of long-term follow-up averaged 4 years and a half, of which 6 cases were still postoperative epistaxis, purpura performance, bleeding tendency improved compared with preoperative, postoperative intermittent hormone therapy. 2 cases of adrenal crisis after the sudden death. One case died of drowning in one and a half years after operation. 38 cases were cured, the effective rate was 81%. Emphasis is placed on surgical perioperative management to prevent crisis of adrenocortical failure. Application of autologous spleen transplantation in ITP cases.