Splenectomy for Immune Thrombocytopenic Purpura

摘要: • Of 481 splenectomies performed at the University of Utah, Salt Lake City, 78 (16.2%) were for immune (idiopathic) thrombocytopenic purpura (ITP). The mean platelet count prior to therapy was 13,800/cu mm (range, 500 80,000/cu mm). All but two patients initially treated with corticosteroids, and 58.2% responded an increase in platelets (mean, 77,900/cu indications splenectomy included (1) failure respond steroids (33.8%); (2) inability taper (52.1%); (3) recurrent ITP (5.6%); (4) miscellaneous (8.5%). There one death following splenectomy, postoperative morbidity 14.1%. Complete remission occurred 77.3%, 84.8% judged have benefited from procedure. rate who preoperative 93.2%, whereas improvement fell 68.3% failed steroids. This study confirms benefit demonstrates a predictive correlation response preparation corticosteroids these patients. (Arch Surg1981;116:645-650)