自体肾移植术治疗顽固性肾血管性高血压的临床价值(附5例报告)  

Renal autotransplantation for treatment of intractable renovascular hypertension(Report of five cases)

作　　者：李俊平[1,2] 潘敏杰 张龙[1] 郭琛[1] 李恒[1] 王振迪[1] 蒋国松[1] 曾甫清[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院泌尿外科,武汉430022 [2]湖北省荆门市第一人民医院泌尿外科 [3]江苏省常州市第二人民医院泌尿外科

出　　处：《临床泌尿外科杂志》2014年第2期137-139,共3页Journal of Clinical Urology

摘　　要：目的：总结采取自体肾移植术（renalautotransplantation，RAT）治疗因重度肾动脉狭窄（renalarter-Ystenosis，RAs）所致顽固性肾血管性高血压（intractablerenalvascularhypertension，IRVH）的经验并探讨其临床应用价值。方法：回顾性分析武汉协和医院收治5例IRVH患者的临床资料及随访结果，观察术后患者血压改善情况及移植肾功能状况，并复习相关文献。结果：4例单侧重度RAS患者术后血压均降至正常范围，于术后20～35天停服降压药物。1例双侧RAS患者左侧行自体肾移植术后血压明显下降，出院后1个月右侧行经皮腔内肾动脉支架成形术（percutaneoustransluminalrenalarterystentingPTRAS），术后63天停服降压药物。随访6个月～3年，5例患者血压维持在正常范围，移植肾功能正常。结论：针对于肾动脉重度狭窄的患者，当无法行PTRAS术时，RAT可作为首选的治疗方法，而且疗效确切。Objective:To summarize the experience of renal autotransplantation(RAT)for intractable renal vascular hypertension(IRVH)caused by severe renal artery stenosis(RAS)in five patients and to explore the clinical application value of RAT.Method:The clinical data and follow-up results of five patients undergoing RAT were reviewed retrospectively,then we observed postoperative blood pressure and graft function during the followup period,and reviewed related literatures.Result:Postoperative blood pressure of four patients with unilateral RAS dropped to normal range after RAT.They stopped taking antihypertensive drugs 20-35 days postoperatively.Postoperative blood pressure of a case of bilateral RAS decreased significantly after left RAT.Furthermore, percutaneous transluminal renal artery stenting(PTRAS)was applied to the right renal artery a month after RAT.In the end,antihypertensive drugs was stopped taking 63 days after the second operation.Blood pressure and graft function of all patients were maintained well during follow-up period of six months to three years.Conclusion:Renal autotransplantation(RAT)can be appropriate for patients with severe renal artery stenosis that couldn't be treated with PTRAS.It is a safe and successful procedure considering satisfying results.

关 键 词：自体肾移植 肾血管性高血压 肾动脉狭窄 

分 类 号：R692.16[医药卫生—泌尿科学]