腔内隔绝术治疗胸主动脉夹层动脉瘤对血压和肾功能的影响

Effect of endovascular graft exclusion on blood pressure and renal function in thoracic aortic dissection

目的探讨胸主动脉夹层动脉瘤经腔内隔绝术治疗后对血压和肾功能的影响。方法采用回顾性分析的方法,选择2010年1月至2017年6月在玉溪市人民医院暨昆明医科大学第六附属医院确诊并行腔内隔绝术的胸主动脉夹层动脉瘤患者共110例,术前检测所有患者血压和肾功能,肾功能检测包括血清尿素氮(BUN)和肌酐(Cr),并按照两项指标将患者分为高血压组78例,正常血压组32例,肾功能正常组76例,肾功能异常组34例。手术后定期监测所有患者的血压水平和肾功能情况,分析腔内隔绝术对患者血压和肾功能的影响。结果研究结果显示,高血压组患者术后2个月的血压较术前有明显下降,差异有统计学意义(P<0.05),而正常血压组患者血压无明显变化;所有患者无论是肾功能正常组还是肾功能异常组患者,其血清BUN、Cr指标较术前均无明显变化,说明腔内隔绝术对肾功能的影响较小,但肾动脉造影显示供血情况可有所改善。结论胸主动脉夹层动脉瘤患者行腔内隔绝术后,血压可在原有高血压基础上有所下降,而血压正常者不受影响,肾动脉血流情况也有所改善,但对肾功能影响不大。

Objective To investigate the effect of endovascular occlusion of thoracic aortic dissection on blood pressure and renal function. Methods A total of 110 patients with thoracic aortic dissecting aneurysms were enrolled Yuxi People＇s Hospital and Hepatobiliary Surgery, the Sixth Affiliated Hospital of Kunming Medical University from January 2010 to June 2017, and all patients with blood pressure were measured by retrospective analysis,（BUN） and creatinine（Cr） were measured. The patients were divided into two groups： hypertension group of 78 cases, normal blood pressure of 32 cases, normal renal function group of 76 cases, renal function Abnormal group of 34 cases. The blood pressure level and renal function of all patients were monitored regularly after operation, and the effects of endovascular exclusion on blood pressure and renal function were analyzed. Results The blood pressure of the hypertensive group was significantly lower than that of the control group（P〈0.05）, but there was no significant change in the blood pressure of the normal blood pressure group Functional normal group or renal dysfunction patients, the serum BUN, Cr indicators were no significant changes compared with preoperative, indicating that the effect of endovascular exclusion on renal function is small, but renal artery angiography shows that the blood supply situation may be improved. Conclusions The thoracic aortic dissecting aneurysm patients after endovascular exclusion, blood pressure can be based on the original high blood pressure decreased, and normal blood pressure are not affected, renal artery blood flow also improved, but the impact of renal function big.