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目的 评估支架置入重建血运治疗肾动脉狭窄的安全性与近中期临床疗效。方法 1999年至 2003年,我院连续 150例肾动脉严重狭窄的患者,其中男性 93例 ( 62. 0% ),女性 57例(48. 0% ),年龄 13~82岁,平均(52±19)岁, 病因分别为动脉粥样硬化 96例(64 0% )、大动脉炎 44例(29. 3% )和纤维肌性结构不良 10例 (6 .7% ),因严重高血压或伴有肾功能不全而进行了支架置入, 随诊 6个月,观察手术对患者血压、肾功能的影响。结果 150例患者中,支架置入成功 148例(98 7% ),病变处管腔直径狭窄从 65% ~100% (85 .5% ± 12. 3% )降至 0 ~25% ( 7 .6% ±5 2% ),管腔最小直径从 0~2 7mm (1 6±0. 9mm)增至 4 5~8 0mm(6 0 ±1 1mm)。6个月随诊时, 患者血压明显下降(P<0 001), 收缩压从(169 .6±32. 5)mmHg(1mmHg=0 133kPa)降至(142 .7±28 .1)mmHg,舒张压从(97 .3±17 .8)mmHg降至 (83 .3±15. 2)mmHg,服用降压药明显减少 (从2 7种减至 1 9种, P<0 001)。其中 48例(32 0% )治愈, 78例(52 0% )改善, 22例(16. 0% )无效。术后血肌酐改善 34例(22. 7% )、无变化 112例 ( 74 .6% )及恶化 4例 ( 2. 7% ),总体上差异无统计学意义。肾动脉支架置入的手术并发症共 12例(8% )。6个月随诊期间无死亡。结论 支架置入重建血运治疗肾?
Objective To evaluate the safety and near-mid-term clinical efficacy of stent implantation in the reconstruction of renal artery stenosis. Methods From 1999 to 2003, 150 consecutive patients with severe renal artery stenosis in our hospital, including 93 males (62.0%) and 57 females (48.0%), aged 13-82 years (average 52 ± 19) years old, the causes were atherosclerosis in 96 cases (64 0%), aortic arteritis in 44 cases (29.3%) and fibromuscular dysplasia in 10 cases (6.7%), due to severe hypertension or with A renal insufficiency and stent placement, followed up for 6 months to observe the impact of surgery on patients with blood pressure, renal function. Results Among the 150 patients, stent placement was successful in 148 cases (98.7%) and the diameter of the lumen was reduced from 65% to 100% (85.5 ± 12.3%) to 0-25% (7. 6% ± 5 2%). The minimum lumen diameter increased from 0 ~ 27mm (16 ± 0. 9mm) to 45 ~ 80mm (60 ± 1 1mm). At 6 months of follow-up, the patient’s blood pressure decreased significantly (P <0.001) and systolic blood pressure decreased from (169.6 ± 32.5) mmHg (1 mmHg = 0,133 kPa) to (142.7 ± 28.1) Diastolic blood pressure decreased from (97.3 ± 17.8) mmHg to (83.3 ± 15.2) mmHg, and antihypertensive drugs were significantly reduced (from 27 to 19, P <0.001). Among them, 48 cases (32 0%) were cured, 78 cases (52 0%) were improved, and 22 cases (16.0%) were invalid. Postoperative serum creatinine improved in 34 cases (22.7%), no change in 112 cases (74.6%) and exacerbations in 4 cases (2.7%), the overall difference was not statistically significant. Renal artery stent placement complications in 12 cases (8%). No death during 6 months follow-up. Conclusion Stent implantation in the reconstruction of blood treatment of kidney?