Immune thrombocytopenic purpura

When it comes to the disease of immune thrombocytopenic purpura, we have to say that it is extremely harmful to our human body. Not only can it easily damage our immune system, but it can also cause unexplained hemorrhagic diseases and even threaten our lives and cause death. So what is the cause of immune thrombocytopenic purpura? How should it be treated?

In fact, the formation of purpura is mainly caused by thrombocytopenia. The immune decrease in platelet count is called immune thrombocytopenic purpura. Although its incidence rate is not high, the mortality rate is quite high. How to treat immune thrombocytopenic purpura?

Causes of immune thrombocytopenic purpura

1. Immune factors: The direct cause of thrombocytopenia is increased platelet destruction, that is, the survival time of platelets is significantly shortened. The cause is the presence of anti-platelet antibodies in the patient's plasma, which have a destructive effect on both the same and one's own platelets.

2. Vascular factors: Clinically, it is found that the degree of bleeding in some patients is disproportionate to the decrease in platelet count. This may be related to the bleeding of this disease and capillary dysfunction. For example, after splenectomy, although the platelet count does not increase in some cases, bleeding phenomena may improve; after treatment with adrenal cortical hormones, the platelet count may not increase, but the capillary fragility test will turn negative and bleeding may also be alleviated. All of these are sufficient to illustrate the importance of capillary defects in bleeding in this disease.

3. Spleen factors: Studies have found that the spleen may be one of the important sites for the production of antiplatelet antibodies. When the spleen produces a large amount of antiplatelet antibodies, normal platelets become sensitized by combining with the antiplatelet antibodies through the spleen. The sensitized platelets are easily phagocytosed by macrophages, so the platelet count in the patient's peripheral blood is significantly reduced.

4. Genetic factors: Studies have shown that patients and their immediate healthy family members have varying degrees of immunological deficiencies, suggesting that the disease may be closely related to genetics.

Treatment options

Splenectomy can provide long-term remission for patients, with a remission rate of 85%, and is the most common indication for splenectomy in hematological diseases.

Preoperative preparation: 1. For patients with portal hypertension, liver function should be improved and bleeding tendency should be corrected before surgery. 2. For some patients with severe anemia, repeated blood transfusions should be performed before splenectomy. 3. For those who use hormones for a long time, antibiotics should be used preventively. 4. Prepare for abdominal surgery as per general surgery procedure.

Anesthesia requirements: endotracheal intubation anesthesia.

Points to note during surgery: 1. The operation can be performed through an "L"-shaped incision below the left rib margin or in the middle of the upper abdomen to fully expose the surgical field. 2. The splenic artery should be ligated before incision. 3. After splenectomy, a drainage tube should be placed in the splenic fossa. 4. Patients with blood diseases must have the accessory spleen removed. 5. When removing the spleen, be careful not to damage the tail of the pancreas to avoid postoperative pancreatic fistula.

Postoperative treatment: 1. Follow the general postoperative treatment of abdominal surgery. 2. The drainage tube is usually removed 24 to 48 hours after surgery. 3. Check white blood cells and platelets daily after surgery. After surgery, when the platelet count exceeds (0.8～1)×1012/L, anticoagulant therapy should be performed.

Regarding the treatment of immune thrombocytopenic purpura, generally speaking, the most common treatment is splenectomy. In addition, this treatment option currently has a remission rate of up to 85%, and the surgical procedure is not complicated. However, everyone must choose a regular and highly professional hospital, so as to greatly reduce the risk of surgery.