儿童先天性肾发育不全致高血压6例

Six Cases Reports With Hypertension Caused by Congenital Renal Dysplasia in Children

目的探讨肾发育不全所致肾血管性高血压的治疗。方法回顾性分析13年间收治的6例患儿的诊断与手术治疗。结果6例患儿均行手术治疗,术中见肾脏小,肾动脉全程狭窄,直径0.1～0.2cm,遂将发育不全的肾脏切除。病理检查示肾实质薄,肾小球数目减少,肾动脉壁未见炎性细胞浸润,无纤维肉芽组织增生。术后血压下降,随访50d～1年,血压均恢复正常,1例患儿术后8个月因合并大动脉炎致对侧肾动脉狭窄,血压回升。结论肾发育不全致高血压,手术切除患肾,效果良好。

Objective To report hypertension caused by congenital renal dysplasia.Methods Six cases with congenital renal dysplasia (male2,famale4)were admitted from Jan1985to Jan1998.The dysplasia kidneys were all resected.Results During the operation,we found that the size of kidney was much smaller than the normal ones,and the whole renal artery of each case was stenosed(diameter0.1～0.2cm).Pathologic studies indicated that renal parechymas got thinner and the amount of renal glomerulus turned small.Inflammatory cell infiltration and fibrogranulation tissue proliferation on renal artery vascular wall were no found.After operation,blood pressure of patients was reduced.Followed-up for three months to one year,hypertension of patients were recovered to normal except that one child who had complication of contralateral renal artery stenosis at eight months after the operation.Conclusions The best way of treating hypertension caused by congenital renal dysplasia is being resect the dysplasia renal.