本文選題：粥樣硬化性腎動脈狹窄 + 經(jīng)皮腔內(nèi)腎動脈成形術(shù)　； 參考：《大連醫(yī)科大學》2014年碩士論文

【摘要】：目的：探討研究動脈粥樣硬化性腎動脈狹窄血管腔內(nèi)治療的適應證、圍手術(shù)期處理、術(shù)后支架再狹窄、治療前后患者血壓及腎功能的變化情況。 資料和方法：收集分析我院2009年1月至2013年1月接受經(jīng)皮腔內(nèi)腎動脈成形術(shù)的32例動脈粥樣硬化性腎動脈狹窄患者的臨床資料，記錄和評估圍手術(shù)期及術(shù)后隨訪12-24個月(平均15個月)支架再狹窄情況、血壓控制情況、抗高血壓藥用藥情況及血肌酐值。 結(jié)果：32例接受PTRA患者中，技術(shù)成功率100%，隨訪1年時，1例女性患者術(shù)后出現(xiàn)支架再狹窄，，狹窄程度為輕中度，無明顯臨床癥狀，其余31例患者未見再狹窄征象。術(shù)后1天及隨訪1年的血壓和服用降壓藥物情況，分別與術(shù)前進行比較。術(shù)后1天血壓較術(shù)前有明顯下降（p0.05,）；隨訪1年時，患者收縮壓由術(shù)前（155±16）mmHg降至（135±20）mmHg，(P＜0.05)；舒張壓自術(shù)前（84±15）mmHg降至隨訪時（74±12）mmHg，(P＜0.05)�；颊咝g(shù)后1天血壓控制的臨床有效率（治愈+改善）為：78.12%，術(shù)后隨訪1年時，患者血壓控制的臨床有效率為68.75%;服用的降壓藥物種類從PTRA前的平均2種減少到1種或停藥。隨訪時，5例PTRA術(shù)前腎功不全的患者血清肌酐值雖然較術(shù)前水平下降，但P＞0.05，無統(tǒng)計學意義。 結(jié)論：本研究表明血管腔內(nèi)治療ARAS術(shù)后的患者，支架再狹窄的發(fā)生率很低，對ARAS引起的繼發(fā)性高血壓，通過血管腔內(nèi)治療可以得到有效控制，血管腔內(nèi)治療并發(fā)癥的發(fā)生率很低，同時有很高的技術(shù)成功率，是一種安全有效的方法，在臨床上有較大的應用價值。然而經(jīng)皮腔內(nèi)腎動脈成形術(shù)對腎功能不全患者的的腎功能的保護和改善作用則有待進一步研究。
[Abstract]:Objective: to study the indications of endovascular treatment for atherosclerotic renal artery stenosis, perioperative management, stent restenosis, and the changes of blood pressure and renal function before and after treatment.Materials and methods: the clinical data of 32 patients with atherosclerotic renal artery stenosis underwent percutaneous transluminal renal angioplasty in our hospital from January 2009 to January 2013 were collected and analyzed.The restenosis of stents, blood pressure control, antihypertensive drugs and serum creatinine were recorded and evaluated during the perioperative period and follow-up for 12-24 months (mean 15 months).Results among 32 patients receiving PTRA, the technical success rate was 100%. After one year of follow-up, one female patient developed stent restenosis, the degree of stenosis was mild and moderate, and there were no obvious clinical symptoms. The other 31 patients had no signs of restenosis.Blood pressure and antihypertensive drugs were compared 1 day after operation and 1 year follow-up.1 day after operation, the blood pressure decreased significantly (P < 0.05), the systolic blood pressure (SBP) decreased from 155 鹵16)mmHg to 135 鹵20mm HgU (P < 0.05), and the diastolic blood pressure (DBP) decreased from 84 鹵15)mmHg to 74 鹵12mm HgGG at follow-up (P < 0.05).One day after operation, the clinical effective rate of blood pressure control (cure improvement) was 1: 78.12. The clinical effective rate of blood pressure control was 68.755.The type of antihypertensive drugs was reduced from 2 before PTRA to 1 or stopped.The serum creatinine levels in 5 patients with renal insufficiency before PTRA were lower than those before PTRA, but there was no statistical significance (P > 0.05).Conclusion: this study shows that the incidence of stent restenosis is very low in patients after ARAS. The secondary hypertension caused by ARAS can be effectively controlled by endovascular therapy.Endovascular therapy has a low incidence of complications and a high technical success rate. It is a safe and effective method and has great clinical application value.However, the effect of percutaneous transluminal angioplasty on renal function in patients with renal insufficiency needs further study.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R699.2

【參考文獻】

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1 王芳,王梅,王海燕;動脈粥樣硬化患者腎動脈狹窄患病率的調(diào)查[J];中華腎臟病雜志;2005年03期

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