CAJ | 학술논문

目的：探讨腹腔镜脾切除术（LS）应用于治疗免疫性血小板减少症（ITP）的有效性和安全性。方法选取2011年12月至2012年12月就诊于该院的IT P患者230例，分为两组，每组115例。对照组患者按常规治疗方法进行开腹脾切除术（OS ）治疗，观察组采用LS进行治疗。比较两种手术方法的手术时间、住院时间、术中出血量以及血小板计数等指标的差异，以及两种手术方法的临床疗效和不良反应发生情况。结果观察组的手术时间、住院时间明显缩短（ t＝17．49、t＝14．51，P＜0．05），术中出血量显著降低（t＝37．31，P＜0．05），血小板计数明显升高（t＝25．64，P＜0．05）；总有效率为96．52％，明显高于对照组的86．09％（χ2＝9．35，P＜0．05）；观察组的不良反应率、复发率分别为6．09％、6．96％，明显低于对照组的10．43％、19．13％（χ2＝8．35、χ2＝8．75，P＜0．05）。结论 LS应用于治疗ITP的疗效确切，有效率高，不良反应和复发率较低。
목적：탐토복강경비절제술（LS）응용우치료면역성혈소판감소증（ITP）적유효성화안전성。방법선취2011년12월지2012년12월취진우해원적IT P환자230례，분위량조，매조115례。대조조환자안상규치료방법진행개복비절제술（OS ）치료，관찰조채용LS진행치료。비교량충수술방법적수술시간、주원시간、술중출혈량이급혈소판계수등지표적차이，이급량충수술방법적림상료효화불량반응발생정황。결과관찰조적수술시간、주원시간명현축단（ t＝17．49、t＝14．51，P＜0．05），술중출혈량현저강저（t＝37．31，P＜0．05），혈소판계수명현승고（t＝25．64，P＜0．05）；총유효솔위96．52％，명현고우대조조적86．09％（χ2＝9．35，P＜0．05）；관찰조적불량반응솔、복발솔분별위6．09％、6．96％，명현저우대조조적10．43％、19．13％（χ2＝8．35、χ2＝8．75，P＜0．05）。결론 LS응용우치료ITP적료효학절，유효솔고，불량반응화복발솔교저。
Objective To investigate the efficacy and safety of laparoscopic splenectomy (LS) in the treatment of immune throm-bocytopenia(ITP) .Methods 230 cases of ITP were collected in this hospital from December 2011 to December 2012 and randomly divided into two groups with 115 cases in each group .Among them ,the control group was treated by the conventional treatment of open splenectomy(OS) ,while the observation group was treated by LS .The differences of the operative time ,hospitalization dura-tion ,intraoperative blood loss and platelet count ,clinical effects and the occurrence situation of adverse reactions were compared be-tween the two kinds of operation method .Results The operative time and the length of hospital stay in the observation group were significantly shortened compared with the control group (t=14 .706 ,t=13 .625 ,P<0 .05);intraoperative blood loss was significant-ly decreased(t=18 .238 ,P<0 .05) and the platelet count was significantly increased (t=17 .248 ,P<0 .05);the total effective rate of the observation group was 96 .52% ,which was significantly higher than 86 .09% of the control group ,(χ2 =9 .35 ,P<0 .05);the adverse reaction rate and the recurrence rate in the observation group were 6 .09% and 6 .96% respectively ,which were significantly lower than 10 .43% and 19 .13% in the control group(χ2 =8 .35 ,χ2 =8 .75 ,P<0 .05) .Conclusion LS for treating immune throm-bocytopenia has definite efficacy with high effective rate ,low adverse reactions and low recurrence rate .