经皮腔内血管成形术及支架治疗儿童和青少年肾动脉狭窄短期及长期疗效

发布时间：2018-07-09 14:24

本文选题：儿童 + 青少年　；参考：《中国介入影像与治疗学》2015年07期

【摘要】：目的评估经皮经腔内血管成形术(PTA)及支架治疗儿童和青少年肾动脉狭窄的短期及长期疗效。方法分析34例接受PTA及支架治疗的儿童和青少年肾动脉狭窄患者,并分为肌纤维发育不良(FMD,n=17)和大动脉炎(TA,n=17)两组,术后短期(围手术期30天)、3、6、12个月进行随访,之后每隔1年随访。记录介入治疗前及随访期血压,采用限定每日剂量(DDD)比较介入治疗前后药物剂量变化,比较介入治疗前后血肌酐水平,并比较两组的疗效。结果34例患者(40支病变肾动脉)接受PTA,手术成功率为90.00%(36/40)。随访中位时间30.0个月。随访期间血压较术前明显下降(P0.001)。患者术后短期DDD较术前无明显变化(P0.05);但术后3个月、1年、3年、5年较术前差异有统计学意义(P0.05)。随访期间平均血肌酐较术前无明显变化(P0.05)。患者术后1年、3年、5年总体获益率(治愈+改善)分别为89.54%、66.89%、61.53%。随访期间FMD组的总体治愈率高于TA组。结论采用PTA及支架治疗儿童和青少年RAS安全可靠,且短期及长期临床获益良好。PTA治疗对于FMD患者获益程度大于TA患者。
[Abstract]:Objective to evaluate the short-term and long-term effects of percutaneous transluminal angioplasty (PTA) and stent for the treatment of renal artery stenosis in children and adolescents. Methods 34 children and adolescents with renal artery stenosis received PTA and stent treatment were divided into two groups of FMD (n=17) and Takayasu arteritis (TA, n=17). Period of 30 days), followed up for 3,6,12 months, followed up every 1 years. Record the blood pressure before and after intervention treatment, use limited daily dose (DDD) to compare the changes of drug dosage before and after intervention therapy, compare the serum creatinine level before and after interventional therapy, and compare the curative effect of two groups (40 cases of renal artery) accept PTA, the success rate of the operation. 90% (36/40). The median time of follow-up was 30 months. During the follow-up period, the blood pressure was significantly lower than that before the operation (P0.001). There was no significant change in short-term DDD after operation (P0.05), but 3 months, 1 years, 3 years and 5 years were statistically significant (P0.05). The mean blood creatinine was not significantly changed (P0.05) during the follow-up period (P0.05). The patients were 1 years, 3 years after operation. The total benefit rate of 5 years (cure + improvement) was 89.54% and 66.89% respectively. The overall cure rate of FMD group was higher than that of group TA during the follow-up period of 61.53%.. Conclusion PTA and stents were used to treat children and adolescents with RAS safe and reliable, and the short-term and long-term clinical benefit was good, and.PTA treatment was more beneficial to FMD patients than those of TA patients.
【作者单位】：北京大学第一医院介入血管外科;
【分类号】：R699.2;R816.7

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