延髓显微血管减压术治疗原发性高血压

Microvascular decompression in the treatment of primary hypertension

目的探讨延髓显微血管减压术(MVD)治疗原发性高血压的疗效。方法我们选取3例病人,他们都曾经接受过3种以上的抗高血压药物的治疗,血压均没有被很好地控制。术前经头DSA、MRI检查,提示左侧延髓腹外侧区有血管压迫,均进行了Ⅸ和Ⅹ颅神经入脑区的MVD,并且对术前术后的血压及激素的变化进行比较。结果平均随访9个月,3例病人术后血压均有不同程度下降,肾上腺素、去甲肾上腺素明显下降。结论有这样一组原发性高血压,他们的高血压与延髓腹外侧的血管压迫有关,而且可能通过延髓MVD被治疗。

Objective To determine the therapeutic effect of microvascular decompression on primary hypertension. Methods We include 3 patients who had received three or more antihypertensive drugs without adequate control of blood pressure. All patients underwent microvascular decompression at the root-cntry zone of cranial nerves Ⅸ and Ⅹ after neurovascular compression of ventrolateral medulla oblongata was seen on DSA and MRI. Results 9 months after surgery,all patients＇blood pressure had decreased. Conclusion Asubgroup of patients with essential hypertension can exist who have secondary forms of hypertension related to neurovascular compression at the ventrolateral medulla and who may be successfully treated with decompression.