巧克力球囊在粥样硬化性肾动脉狭窄治疗中的近期临床疗效分析  

Short-term clinical effect of chocolate balloon in the treatment of atherosclerotic renal artery stenosis

作　　者：何超杰 王兵[1] 王浩 耿金宝 王梦宇 He Chaojie;Wang Bing;Wang Hao;Geng Jinbao;Wang Mengyu(Department of Vascular Surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,He'nan,China)

机构地区：[1]郑州大学第五附属医院血管外科,河南郑州450052

出　　处：《血管与腔内血管外科杂志》2022年第3期288-292,共5页Journal of Vascular and Endovascular Surgery

基　　金：河南省高等学校重点科研项目(21A320069)。

摘　　要：目的分析及评价巧克力球囊治疗粥样硬化性肾动脉狭窄(ARAS)的近期临床疗效。方法收集2020年7月至2021年3月郑州大学第五附属医院收治的24例ARAS患者的临床资料。根据治疗方式的不同将患者分为观察组(使用巧克力球囊进行介入治疗)和对照组[采用肾动脉支架置入术(PTRAS)进行治疗],每组12例。比较两组患者的手术成功率。通过术中肾动脉造影检查观察靶血管狭窄处的通畅情况、术中有无限流性夹层形成。观察并比较两组患者不同时间点(术前、术后1个月、术后6个月)的收缩压、肾动脉收缩期峰值流速(PSV)、血清肌酐(SCr)水平。记录心肾血管事件的发生情况,观察术后是否发生急性再狭窄或闭塞。比较两组患者术后1、6个月影像学检查结果、收缩压的控制情况,服用降压药物数量的变化情况,肾动脉PSV、SCr水平的变化情况。结果两组患者的手术成功率均为100%。术后造影检查结果显示,两组患者的靶血管残余狭窄率均<30%。术中,两组患者限流性夹层的发生率比较,差异无统计学意义(P>0.05)。术后1、6个月,两组患者均未发生急性再狭窄或闭塞,未出现腹腔内出血、急性肾功能不全、肾功能衰竭等严重并发症。两组患者术后临床症状均明显改善,口服降压药物的种类或数量均减少。两组患者不同时间点(术前、术后1个月、术后6个月)的收缩压、肾动脉PSV、SCr水平比较,差异均无统计学意义(P>0.05);术后1、6个月,两组患者的收缩压、肾动脉PSV均低于本组术前,差异均有统计学意义(P<0.05);两组患者的SCr水平较本组术前略有下降,但差异均无统计学意义(P>0.05)。结论应用巧克力球囊治疗ARAS安全有效,近期临床效果显著。Objective To analyze and evaluate the short-term clinical effect of chocolate balloon in the treatment of atherosclerotic renal artery stenosis(ARAS).Method The clinical data of 24 patients with ARAS admitted to the Fifth Affiliated Hospital of Zhengzhou University from July 2020 to March 2021 were collected.They were divided into observation group and control group according to surgical methods,with 12 patients in each group.The control group received percutaneous transluminal renal angioplasty with stenting(PTRAS)and the observation group received interventional therapy with chocolate balloon.The operative success rates of the two groups were compared.The patency of target vessel stenosis and occurrence of current limiting interlayer formation were observed by intraoperative renal arteriography.The systolic pressure,peak systolic velocity(PSV)of renal artery,and serum creatinine(SCr)level were observed and compared between the two groups at different time points(before operation,1 month after operation and 6 months after operation).The occurrence of cardiovascular and renal vascular events were recorded,and whether there is acute restenosis or occlusion after operation were observed.The imaging results,the control of blood pressure,changes in the number of antihypertensive drugs,and the changes of PSV of renal artery and SCr levels were compared between the two groups at 1 and 6 months after operation.Result The operative success rate of both the observation group and the control group was 100%.The results of postoperative angiography showed that the residual stenosis of target vessels in both groups was less than 30%.During the operation,there was no significant difference in the incidence of the current limiting interlayer formation between the two groups(P>0.05).At 1 and 6 months after operation,there were no acute restenosis or occlusion,intraperitoneal hemorrhage,acute renal insufficiency,renal failure and other serious complications in both groups.The clinical symptoms of the two groups were significantly

关 键 词：粥样硬化性肾动脉狭窄 巧克力球囊 肾动脉支架置入术 支架内再狭窄 

分 类 号：R543.5[医药卫生—心血管疾病]