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目的探讨血管内介入治疗动脉粥样硬化性肾动脉狭窄的临床疗效。方法选择2013年1月至2016年2月内蒙古赤峰市医院收治的行血管内介入治疗的25例肾动脉狭窄患者,其中单侧肾动脉狭窄16例,双侧肾动脉狭窄9例,3例患者伴有肾萎缩。分析血管内介入治疗的临床因素与疗效的相关性。结果手术成功率为100%,所有患者术后3 d血压均改善,治愈患者5例,改善患者20例,术中及围手术期患者均未出现严重并发症,术后部分患者肾功能改善。治疗后,所有患者肾素水平均有不同程度下降。单因素相关性分析显示,低龄、高血压病程短的患者术后血压改善明显,高龄、高血压病程长的患者受益相对小。结论血管内介入治疗动脉粥样硬化导致的肾动脉狭窄具有安全、手术成功率高的优点,严格把握手术指征,患者均能获益。年龄、高血压的病程和程度以及肾动脉狭窄的程度均影响肾动脉的血管内介入治疗效果。
Objective To investigate the clinical effect of endovascular interventional treatment of atherosclerotic renal artery stenosis. Methods From January 2013 to February 2016, 25 patients with renal artery stenosis treated by endovascular intervention in Chifeng City Hospital of Inner Mongolia were enrolled. Among them, 16 patients had unilateral renal artery stenosis, 9 patients had bilateral renal artery stenosis, and 3 patients With renal atrophy. To analyze the correlation between clinical factors and curative effect of endovascular interventional therapy. Results The successful rate of operation was 100%. All patients’ blood pressure was improved 3 days after operation. Five patients were cured and 20 patients were improved. No serious complications occurred during operation and perioperative period. Renal function improved in some patients after operation. After treatment, all patients with renin levels have decreased to varying degrees. Univariate correlation analysis showed that patients with younger age and shorter duration of hypertension had better postoperative blood pressure, while those with advanced age and long duration of hypertension benefited relatively less. Conclusion Endovascular interventional treatment of atherosclerosis caused by renal artery stenosis is safe, the advantages of high success rate of surgery, strict indications for surgery, patients can benefit. Age, the course and degree of hypertension, and the extent of renal artery stenosis all influence the effect of intra-arterial interventional therapy.