术前血小板计数与腹腔镜脾切除术治疗特发性血小板减少性紫癜疗效的关系

目的探讨术前血小板计数与腹腔镜脾切除术（LS）治疗特发性血小板减少性紫癜（ITP）疗效的关系。方法回顾性分析98例有随访资料、经LS治疗ITP患者的临床资料，根据术前1d血小板（PLT）计数分为3组：Ⅰ组PLT计数〈50×10^9／L，Ⅱ组PLT计数在（50～100）×10^9／L，BI组PLT计数〉100×10^9／L。比较：，组间的手术结果指标及长期血液学疗效，定量资料比较采用单因素方差分析或秩和检验，定性资料比较采用X2或秩和检验。结果3组患者手术时间、术后48h引流量、术后第1天的PLT计数和术后住院天数的差异均有统计学意义（P〈0．05）。中位随访时间为34．5个月，其血液学疗效有明显差异（P=0．046）。结论ITP患者术前PLT计数与LS手术结果和血液学疗效有密切关系。术前应尽量提升PLT计数，降低手术风险。

Relationship between preoperative platelet count and outcomes of laparoscopic splenectomy for idiopathic thrombocytopenic purpura

Objective To investigate the relationship between preoperative platelet counts and surgical outcomes as well as hematological outcomes of laparoseopie splenectomy（LS） for idiopathic thrombocytopenie purpura（ITP）. Methods Clinical data of 98 ITP cases who underwent LS and had intact follow-up information were analysed retrospectively. The patients were divided into three groups by their preoperative platelet counts： platelet counts〈50 ×10^9/L （Group I ）, platelet counts （50-100）×10^9/L （Group Ⅱ ）, and platelet counts 〉100×10^9/L （Group Ⅲ）. Surgical outcomes and hematological outcomes were compared between the three groups. Comparisons of quantitative variables were carried out using one-way analysis of variance or kruskal-wallis test and qualitative variables were evaluated using ehi-square test or rank-sum test. Results There were statistically significant differences in operative time, postoperative 48-hour drainage, platelet counts of the first postoperative day and hospital stay beteween three groups（P〈0.05）. With the medium follow-up period of 34.5 months, significant difference of the hematological outcomes was observed in three groups（P=0.046）. Conclusions Preoperative platelet counts are closely related to surgical outcomes and hematological outcomes of LS for ITP. Great efforts need be made to elevate preoperative platelet counts to diminish the surgical risk.