射频消融治疗顽固性免疫性血小板减少症

目的探讨脾脏射频消融术治疗顽固性免疫性血小板减少症（ITP）的安全性和有效性。方法回顾分析我院开展的国际首例脾脏射频消融治疗ITP的疗效。结果 1例43岁女性食管癌患者,经反复外周血计数、血涂片和骨髓穿刺等检查证实合并原发性重症ITP,其血小板计数小于（5~10）×109/L,经规范抗幽门螺旋杆菌治疗、静滴人免疫球蛋白、甲基强的松龙、长春新碱和输注血小板等治疗无效。患者接受腹腔镜下脾脏射频消融术治疗,术后第22天血小板计数恢复正常,无围手术期并发症;随访超过8个月,患者呈完全应答。结论脾脏射频消融术治疗顽固性ITP安全、有效,值得扩大临床试验进一步验证其疗效。

Radiofrequency ablation for intractable immune thrombocytopenia

Objective To assess the safety and efficacy of radiofrequency ablation（RFA） of the spleen for intractable immune thrombocytopenia（ITP）.Methods The outcomes of the world＇s first patient undergoing splenic RFA for ITP in 2nd artillery general hospital of PLA was retrospectively reviewed.Results A 44-year-old female with esophageal carcinoma was diagnosed as primary severe ITP（platelet count （5～10）×109/L） by repeated peripheral blood count,blood smear and bone marrow examinations.No therapeutic effect was achieved after applying conventional therapies such as helicobacter pylori eradication,administration of intravenous immunoglobulin,methylprednisolone,vincristine and platelet transfusion.Laparoscopic splenic radiofrequency ablation was performed on the patient.The platelet count recovered normally on 22th day postoperatively and no perioperative morbidities occurred.The complete response to splenic RFA had sustained over eight months up to now.Conclusion Splenic RFA for intractable immune thrombocytopenia is safe and effective.Further clinical trial with more patients is necessary to verify its efficacy.