【摘要】目的探讨脾切除术后血小板计数的变化及处理措施。方法选外伤性脾破裂26例，门脉高压症24例，溶血性贫血3例，原发性血小板减少性紫癜1例，遗传性球形红细胞增多症1例，脾肿瘤1例。脾切除术前查血小板,术后每2日连续查血小板,然后根据情况定期复查。术后血小板上升至400×109/L者,使用抗血小板药物,单独或联合应用。结果发现所有病例术后均有异常的血小板计数升高,大多数在药物处理后30 d左右降至500×109/L以下，仅1例因血管栓塞并发症死亡。结论血小板计数应作为脾切除术后常规监测指标之一，也是有效预防脾脏切除术后门静脉血栓形成的关键。

 【关键词】脾切除术；血小板

 Experience in diagnosis and treatment of the increment of platelets after splenectomy DENG Jian-hong,MENG Chun-ming,LIANG Shun-hua.The Xinjiang Armed Police Hospital, Urumqi 830091,China

 【Abstract】ObjectiveTo investigate the experience in diagnosis and treatment of the increment of platelets after splenectomy.Methods The study comprised 26 patients of external injury, 24 patients of povtal hypertension syndrome, 3 patients of hemolytic anemia, 1 patient of ideopathic thrombocytopenic purpura, 1 patient of hereditary spherocytosis and 1 patient of splenic neoplasms. The levels of platelets were measured before the splenectomy and once per two days after the splenectomy. Then according to the clinical manifestation, the levels of platelets were measured regularly. When the platelets increased to 400×109/L after splenectomy, we used antiplatelet agent, single-handed or combined.Results We found that the levels of platelets of all the patients increased extraordinary, mostly decreased under 500×109/L about 30 days after splenectomy. 1 patient died for the complications of vas embolism. ConclusionThe levels of platelets should be one of the index of routine analysis. At the same time, it is the key step for the prevention of the splenic vein thrombosis after splenectomy. ......
 百拇医药网 http://www.100md.com/html/paper/1674-6805/2011/12/04.htm
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