微血管减压术治疗高血压：综述与更新
Microvascular decompression in the treatment of hypertension: review and update.
作者信息
Levy E I, Scarrow A M, Jannetta P J
机构信息
Department of Neurosurgery, University of Pittsburgh School of Medicine, UPMC Presbyterian Hospital, 200 Lothrop Street, Suite B-400, Pittsburgh, PA 15213-2582, USA.
出版信息
Surg Neurol. 2001 Jan;55(1):2-10; discussion 10-1. doi: 10.1016/s0090-3019(00)00352-9.
BACKGROUND
Neurogenic hypertension in association with vascular compression of the left rostral ventrolateral medulla has been documented. A recent group of these clinical reports has raised great interest in decompression of this area of the brainstem as a definitive therapy for essential hypertension.
METHODS
To further clarify the mechanism by which decompression of the left rostral ventrolateral medulla relieves neurogenic hypertension, we describe in detail the basic science, animal models, human studies, and most recent clinical trials regarding surgical decompression of this area.
CONCLUSION
Multi-disciplinary evidence supports the hypothesis that a sub-population of hypertensive patients achieve significant relief of their hypertension after microvascular decompression. A multi-institutional, prospective, randomized study is necessary to determine the efficacy of microvascular decompression for neurogenic hypertension.
背景
已证实神经源性高血压与左侧延髓头端腹外侧血管受压有关。最近的一组临床报告引发了人们对脑干这一区域减压作为原发性高血压的确定性治疗方法的极大兴趣。
方法
为了进一步阐明左侧延髓头端腹外侧减压缓解神经源性高血压的机制，我们详细描述了关于该区域手术减压的基础科学、动物模型、人体研究及最新临床试验。
结论
多学科证据支持这样的假说，即一部分高血压患者在微血管减压术后高血压得到显著缓解。有必要进行一项多机构、前瞻性、随机研究来确定微血管减压治疗神经源性高血压的疗效。
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