摘要
目的评估支架重建肾动脉血运对缺血性肾病患者肾功能的影响.方法 27例严重动脉粥样硬化性肾动脉狭窄伴有肾功能不全的患者进行了肾动脉支架置入术(PTRAS), 并随诊6～48个月,观察手术对患者肾功能的影响.结果 27例患者中,技术上PTRAS均成功.随诊6、12、24、36个月,患者血肌酐术前为155 μmol/L±31 μmol/L,术后分别为145 μmol/L±22 μmmol/L,143 μmol/L±22 μmol/L,145 μmol/L±24 μmol/L,140 μmol/L±11 μmol/L.手术重要并发症可见7例发生急性肾功能不全,4例为可逆性.结论缺血性肾病行肾动脉支架置入术对肾功能有益,但手术并发症较多,远期疗效有待进一步调查.
Objectives To evaluate the effects of stent revascularization on renal function of patients with atherosclerotic renal artery stenosis with renal insufficiency, Methods Percutaneous transluminal renal angioplasty with stent （PTRAS） was performed on 27 consecutive patients with severe atherosclerotic renal artery stenosis for preservation of renal function, and follow-up was conducted for 6 - 48 months. Results Technically PTRAS was successfully performed in all 27 patients. The creatinine value was 155 μmol/L ± 31 μmol/L before operation, and increased to 189 μmol/L ± 38 μmol/L （P 〈 0. 001 ）,then decreased to 145 μmmol/L ± 22 μmmol/L, 143 μmol/L ± 22 μmol/L, 143 μmol/L ± 24 μmol/L, and 139 μmol/L ± 10 μmol/L、6、12、24, and 36 months after the PTRAS respectively （all P 〈0. 05）. The severe complications related to the procedure mainly included 7 cases of acute renal failure, 4 cases being reversible. One case died of cardiac infarction with underlying coronary heart disease 9 months after and 1 case died heart failure due to valvular disease of heart 25 months after, Conclusion Renal artery stent revascularization is effective for preservation of renal function in patients with ischaemic nephropathy effect on. However, complications related to the procedure frequently occurred. The long-term efficacy is to be investigated further.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2005年第29期2046-2049,共4页
National Medical Journal of China
