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目的:总结采取自体肾移植术(renal autotransplantation,RAT)治疗因重度肾动脉狭窄(renal artery stenosis,RAS)所致顽固性肾血管性高血压(intractable renal vascular hypertension,IRVH)的经验并探讨其临床应用价值。方法:回顾性分析武汉协和医院收治5例IRVH患者的临床资料及随访结果,观察术后患者血压改善情况及移植肾功能状况,并复习相关文献。结果:4例单侧重度RAS患者术后血压均降至正常范围,于术后20~35天停服降压药物。1例双侧RAS患者左侧行自体肾移植术后血压明显下降,出院后1个月右侧行经皮腔内肾动脉支架成形术(percutaneous transluminal renal artery stenting PTRAS),术后63天停服降压药物。随访6个月~3年,5例患者血压维持在正常范围,移植肾功能正常。结论:针对于肾动脉重度狭窄的患者,当无法行PTRAS术时,RAT可作为首选的治疗方法,而且疗效确切。
Objective: To summarize the experience of using renal autotransplantation (RAT) in the treatment of intractable renal vascular hypertension (IRVH) caused by severe renal artery stenosis (RAS) Value. Methods: The clinical data and follow-up results of 5 patients with IRVH admitted to Wuhan Union Medical College Hospital were retrospectively analyzed. The improvement of blood pressure and functional status of renal allograft after operation were observed. Relevant literatures were reviewed. Results: The blood pressure of 4 patients with unilateral severe RAS dropped to the normal range, and the antihypertensive drugs were stopped 20 to 35 days after operation. One patient with bilateral RAS experienced a significant decrease in blood pressure after autologous kidney transplantation on the left side. One month after discharge, percutaneous transluminal renal artery stenting (PTRAS) Pressure drugs. Followed up for 6 months to 3 years, 5 patients with blood pressure remained in the normal range, normal renal graft function. Conclusions: RAT is the preferred treatment for patients with severe renal artery stenosis when PTRAS can not be performed and is effective.