介入治疗肾血管性高血压

Interventional therapy for renal vascular hypertension

目的总结经皮腔内血管成形术（ＰＴＲＡ）＋内支架植入术治疗肾血管性高血压的疗效。方法１９９５～１９９８年介入治疗肾血管性高血压患者２６例。对肾动脉硬化导致的肾动脉近端病变直接行支架植入术。对肾动脉硬化致肾动脉中远端病变及大动脉炎，纤维肌肉发育不良性肾动脉病变先行ＰＴＲＡ术，效果不好或失败者行支架植入术。选择Ｐａｌｍａｚ支架。结果ＰＴＲＡ＋支架植入术技术成功率１００％，近期临床治愈改善率９２．３％，随访治愈改善率８６．４％。结论ＰＴＲＡ＋支架植入术即时安全有效，治愈改善率满意，可作为肾血管性高血压的首选治疗方法。

Objectiv To evaluate the efficacy of percutaneous transluminal renal angioplasty (PTRA) and intraluminal stent implantation for patients with renal vascular hypertension. Methods palmaz stent was directly implanted to the atherosclerotic proximal segment of the renal artery.In case the atherosclerotic lesion,aortoarteritis or fibromuscular dysplasia affected the middle or distal segment of the renal artery,PTRA was performed first and stenting procedure was reserved for cases when the therapeutic result of PTRA has been unsatisfactory. Results The success rate of PTRA and stent placing has been 100%.The shortterm and followup clinical improvement rates were 92.3% and 86.4% respectively. Conclusions PTRA and stenting procedures should be the treatemnt of first choice as they are safe and less traumatic with satisfactory improvement rate.