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目的分析重症特发性血小板减少性紫癜(ITP)治疗的临床疗效及预后转归。方法对21例重症ITP患者初始给予糖皮质激素+静脉免疫球蛋白±血小板输注的联合治疗方案;对幽门螺杆菌感染阳性的患者给予抗HP根治治疗;对多种治疗措施不能持久符合切脾指征的患者行切脾术;观察治疗后临床出血症状及血小板计数的变化。结果 21例联合方案治疗初始完全反应约占90%,无效约占10%;4例幽门螺杆菌检测阳性的患者给予抗HP治疗,2例有效;4例切脾患者3例完全反应。结论初始联合治疗方案对患者度过危险期,改善出血症状疗效显著;对ITP患者应常规行幽门螺杆菌检测;切脾治疗ITP效果肯定。
Objective To analyze the clinical effects and prognosis of severe idiopathic thrombocytopenic purpura (ITP). Methods 21 patients with severe ITP were given glucocorticoid + intravenous immunoglobulin ± platelet transfusion combined treatment; Helicobacter pylori infection-positive patients given anti-HP radical therapy; a variety of treatment measures can not be consistent with the long-term Indications of patients underwent splenectomy; observed after treatment of clinical bleeding and platelet count changes. Results 21 cases of combined treatment of initial complete response of about 90%, about 10% of the invalid; 4 cases of Helicobacter pylori positive patients treated with anti-HP, 2 cases effective; 4 cases of splenectomy in 3 patients completely respond. Conclusions The initial combination therapy has a significant effect on the patients who have passed the dangerous phase and the hemorrhage symptom is improved. Helicobacter pylori test should be routinely performed in patients with ITP, and the ITP effect in splenectomy is affirmed.