论文部分内容阅读
目的评价经皮血管腔内成形术(PTA)及支架置入治疗移植肾动脉狭窄的效果。方法对经造影确诊的13例移植肾动脉狭窄患者行PTA和/或支架置入治疗。分析手术的成功率,治疗前后的动脉血压、肌酐水平等参数。采用t检验用于比较治疗前后的参数。结果 13例中4例行单纯球囊扩张术,8例扩张效果不佳者同期行支架置入术,1例治疗未成功,PTA/支架置入术的成功率为92.3%。随访6～24个月(中位时间为12个月),9例复查示血管内血流通畅。2例单纯球囊扩张分别于术后1和3个月(平均时间2个月)后再狭窄,再次行支架置入术后保持通畅。1例支架闭塞于术后1个月。术前平均肌酐水平为(2.9±1.5)mg/dL,术后1个月下降至(2.0±1.4)mg/dL(P=0.0098<0.01)。收缩压从术前的(157.2±18.7)mmHg下降至术后1个月的(136.6±14.2)mm-Hg(P=0.0029<0.01),舒张压由(89.4±9.3)mmHg下降至(73±9.5)mmHg(P=0.0065<0.01)。结论 PTA及支架置入术是治疗移植肾动脉狭窄安全和有效的方法。
Objective To evaluate the effect of percutaneous transluminal angioplasty (PTA) and stenting on renal artery stenosis. Methods Thirteen patients with renal artery stenosis confirmed by angiography underwent PTA and / or stenting. Analysis of the success rate of surgery, before and after treatment of arterial blood pressure, creatinine and other parameters. T-test was used to compare the parameters before and after treatment. Results Of the 13 cases, simple balloon dilatation was performed in 4 cases and stent implantation was performed in 8 cases with poor dilatation. One case was unsuccessful, and the success rate of PTA / stent placement was 92.3%. All the patients were followed up for 6-24 months (median 12 months), and 9 cases showed recanalization of intravascular blood flow. Two cases of simple balloon dilatation were restenosed after 1 and 3 months (mean time 2 months) respectively, and remained open after stent implantation. One case was occluded 1 month after operation. The preoperative average creatinine level was (2.9 ± 1.5) mg / dL and decreased to (2.0 ± 1.4) mg / dL at 1 month after surgery (P = 0.0098 <0.01). Systolic blood pressure decreased from (157.2 ± 18.7) mmHg preoperatively to (136.6 ± 14.2) mmHg one month postoperatively (P = 0.0029 <0.01), diastolic blood pressure decreased from (89.4 ± 9.3) mmHg to (73 ± 9.5) mmHg (P = 0.0065 <0.01). Conclusion PTA and stent implantation is a safe and effective method for the treatment of renal artery stenosis.