肾动脉狭窄支架植入术的临床疗效观察

目的探讨肾动脉狭窄支架植入术的临床疗效.方法1997年1月～2004年12月,我院行支架介入治疗肾动脉狭窄27例.对27例术前、术后及随访期内血压、肾功能以及生活质量进行评估,并与同期单纯药物治疗肾动脉狭窄27例进行比较.结果介入组27例植入支架40枚,手术成功24例(88.9%,24/27),失败3例(11.1%,3/27),手术并发症5例(18.5%,5/27).术后在血压下降(包括收缩压舒张压)肌酐下降,肾小球滤过率增加方面,介入组获益率明显优于药物组,两组比较差异均有显著性,术后随访6个月～8年6个月,中位数为1年9个月,介入组有19例能比较健康的生活和工作,药物组仅12例能维持生活和工作.结论支架介入治疗较单纯药物治疗肾动脉狭窄疗效显著.

Percutaneous stenting for renal artery stenosis

Objective To evaluate the effect of percutaneous stenting for renal artery stenosis. Methods Stent implantation was conducted in 27 patients(Interventional Group) with renal artery stenosis from January 1997 to December 2004 in this hospital.Patients' blood pressure,renal functions,and quality of life were recorded and compared with another group of 27 patients receiving medical treatment(Medical Group) during this time. Results The procedure of renal artery stenting was superior to the medical treatment in antihypertensive effect,renal function improvement,raise of life quality,and increase of survival rate.The procedure offered a high success rate(88.9%,24/27) and low re-stenosis rate(12.5%,3/24) and an incidence of complications(18.5%,5/27).The Interventional Group was remarkably superior to the Medical Group with respect to the decrease of blood pressure and creatinine and the increase of glomerular filtration rate,with significant differences.Follow-ups for 6 months ~ 8 years and 6 months(median,1 year and 9 months) revealed that normal daily activities and works were achieved in 19 patients in the Interventional Group and in 12 patients in the Medical Group. Conclusions Percutaneous renal artery stenting in the treatment of renal artery stenosis is effective.