腹腔镜脾切除术治疗特发性血小板减少性紫癜

目的：探讨腹腔镜脾切除术治疗特发性血小板减少性紫癜的手术安全性、可行性和临床疗效。方法：回顾性分析35例内科治疗无效的特发性血小板减少性紫癜患者行腹腔镜脾切除术的临床资料。33例成功地完成腹腔镜脾切除术。另2例在腹腔镜脾切除后脾床渗血，施行小切口脾床止血。结果：手术时间70～180min，平均4120min。术中出血量20-600mL，平均120mL。平均住院时间6．4d，无并发症发生。术后随访3～20个月，平均lO个月，19例完全有效，12例部分有效，总有效率88．6％。结论：腹腔镜脾切除术治疗特发性血小板减少性紫癜安全可行、痛苦少、恢复快。

Laparoscopic Splenectomy for Idiopathic Thrombocytopenic Purpura

Objective To evaluate the effectiveness of laparoscopic splenectomy(LS)in the treatment of idiopathic thrombocytopenic purpura(ITP)Methods Clinical data of 35 cases with refractory ITP undergoing LS were analyzed retrospectively.Results Two cases performing LS converted to stop bleeding with small incision laparotomy.Another 33 cases had successful operations of LS.The success rate of LS was 94.3%.The operation time was 70-180 min,the average duration of surgery being 120 min.Blood loss was 20-600 ml(averaging 120 ml).All patients could get out of bed in six hours,passed flatus and start diet within 24 hours.The average hospitalization was 6.4 days.Accessory spleen was removed from six patients.In the series no complications occurred.Follow-up for 3 to 20 months(average 10 months)showed 19 cases of complete response and 12 cases of partial response.The overall response rate was 88.6%.Conclusion LS for ITP can be performed successfully and effectively with less pain as well as quick recovery.