中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2013年
10期
879-881
,共3页
黄军伟%阎雄%郑军%孔宪炳%罗诗樵%张洪宾%唐晓琼%王利
黃軍偉%閻雄%鄭軍%孔憲炳%囉詩樵%張洪賓%唐曉瓊%王利
황군위%염웅%정군%공헌병%라시초%장홍빈%당효경%왕리
紫癜,血小板减少性,特发性%脾切除术%腹腔镜检查%治疗结果%因素分析,统计学
紫癜,血小闆減少性,特髮性%脾切除術%腹腔鏡檢查%治療結果%因素分析,統計學
자전,혈소판감소성,특발성%비절제술%복강경검사%치료결과%인소분석,통계학
Purpura,thrombocytopenic,idiopathic%Splenectomy%Laparoscopy%Treatment outcome%Factor analysis,statistical
目的 探讨腹腔镜脾切除(LS)治疗免疫性血小板减少性紫癜(ITP)疗效的影响因素.方法 对2007年1月至2012年9月78例行LS的ITP患者临床资料进行回顾性分析,根据术后疗效分为有效组和无效组,对9项影响因素进行单因素及多因素分析.结果 在有效组(65例)与无效组(13例)患者中,术前1d中位血小板计数分别为47×109/L和21×109/L,平均手术时间分别为(166±46) min和(139±29) min.单因素分析结果显示,2组患者间术前1d血小板计数(Z=-2.776,P =0.005)及手术时间(t=2.723,P=0.011)差异有统计学意义.多因素分析结果显示,术前1d血小板计数是预测LS治疗ITP疗效的有效指标(OR=0.964,95％ CI:0.932 ～0.997,P=0.031),而手术时间并非有效指标(P=0.051).结论 术前1d血小板计数是一项能有效预测LS治疗ITP疗效的指标.但各种影响因素能否真正起到预测LS治疗ITP疗效的作用,还需进一步通过大样本、多中心、前瞻性研究加以验证.
目的 探討腹腔鏡脾切除(LS)治療免疫性血小闆減少性紫癜(ITP)療效的影響因素.方法 對2007年1月至2012年9月78例行LS的ITP患者臨床資料進行迴顧性分析,根據術後療效分為有效組和無效組,對9項影響因素進行單因素及多因素分析.結果 在有效組(65例)與無效組(13例)患者中,術前1d中位血小闆計數分彆為47×109/L和21×109/L,平均手術時間分彆為(166±46) min和(139±29) min.單因素分析結果顯示,2組患者間術前1d血小闆計數(Z=-2.776,P =0.005)及手術時間(t=2.723,P=0.011)差異有統計學意義.多因素分析結果顯示,術前1d血小闆計數是預測LS治療ITP療效的有效指標(OR=0.964,95％ CI:0.932 ～0.997,P=0.031),而手術時間併非有效指標(P=0.051).結論 術前1d血小闆計數是一項能有效預測LS治療ITP療效的指標.但各種影響因素能否真正起到預測LS治療ITP療效的作用,還需進一步通過大樣本、多中心、前瞻性研究加以驗證.
목적 탐토복강경비절제(LS)치료면역성혈소판감소성자전(ITP)료효적영향인소.방법 대2007년1월지2012년9월78례행LS적ITP환자림상자료진행회고성분석,근거술후료효분위유효조화무효조,대9항영향인소진행단인소급다인소분석.결과 재유효조(65례)여무효조(13례)환자중,술전1d중위혈소판계수분별위47×109/L화21×109/L,평균수술시간분별위(166±46) min화(139±29) min.단인소분석결과현시,2조환자간술전1d혈소판계수(Z=-2.776,P =0.005)급수술시간(t=2.723,P=0.011)차이유통계학의의.다인소분석결과현시,술전1d혈소판계수시예측LS치료ITP료효적유효지표(OR=0.964,95％ CI:0.932 ～0.997,P=0.031),이수술시간병비유효지표(P=0.051).결론 술전1d혈소판계수시일항능유효예측LS치료ITP료효적지표.단각충영향인소능부진정기도예측LS치료ITP료효적작용,환수진일보통과대양본、다중심、전첨성연구가이험증.
Objective To identify factors that can effectively predict the efficacy of laparoscopic splenectomy (LS) in the treatment of immune thrombocytopenic purpura (ITP).Methods From January 2007 to September 2012,78 patients with ITP underwent laparoscopic splenectomy were retrospectively analyzed.According to the postoperative platelet (PLT) count and haemorrhagic manifestations,they were divided into effective group and ineffective group.Nine influencing factors were univariate analyzed and multivariate analyzed.Results In effective group (65 cases) and ineffective group (13 cases),average PLT count of 1 day before surgery was 47 × 109/L vs.21 × 109/L,average operative time was (166 ±46) minutes vs.(139 ± 29) minutes.Univariate analysis result:PLT count of 1 day before surgery (Z =-2.776,P =0.005) and operative time (t =2.723,P =0.011) was statistically significant in 2 groups,the rest factors did not significantly influence the result.Multivariate analysis revealed that only PLT count of 1 day before surgery was statistically significant (OR =0.964,95％ CI:0.932-0.997,P =0.031) in 2 groups,but operative time (P =0.051) was not statistically significant.Conclusions PLT count of 1 day before surgery is a predict factor in LS for ITP.Because of the limited sample number,further multi-center prospective study with large sample is warrant.
