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钝性肾损伤后高血压

[Hypertension following blunt kidney injury].

作者信息

Lebech A, Strange-Vognsen H H

出版信息

Ugeskr Laeger. 1990 Apr 2;152(14):994-7.

PMID:2183457
Abstract

The incidence of hypertension after blunt renal injury is reviewed on the basis of the available literature in English and Danish from 1934 to the present day. The selected literature fulfills defined requirements as regards quality. Hypertension develops one to two days after the trauma and this remits spontaneously after an average of 29 (7-50) days. The reason for this is a perirenal haematoma which produces ischaemic renal tissue by compression after which the haematoma is resorbed. This is demonstrated by urography and investigation of the renin-angiotensin system. The frequency is stated to be 6.7% in an isolated investigation but this must be regarded with reservation. A considerably longer period after the trauma, permanent hypertension develops. This is due to permanent pathological changes which produce ischaemic renal tissue by compression or stenosing of the lumina of the renal arteries. The frequency of this type of hypertension is so low that it cannot be estimated on the basis of the follow-up examinations carried out. These show a frequency of hypertension of between 2.3 and 3.8% which may be explained by the development of spontaneous hypertension. A definite relationship between permanent hypertension and blunt renal injury has only been found in 28 case reports.

摘要

基于1934年至今可用的英文和丹麦文文献,对钝性肾损伤后高血压的发病率进行了综述。所选文献在质量方面满足既定要求。高血压在创伤后一到两天出现,平均29(7 - 50)天后自发缓解。其原因是肾周血肿通过压迫产生缺血性肾组织,之后血肿被吸收。这通过尿路造影和肾素 - 血管紧张素系统的研究得以证实。在一项单独研究中,其发生率据称是6.7%,但对此必须持保留态度。在创伤后相当长一段时间,会出现永久性高血压。这是由于永久性病理变化通过压迫或肾动脉管腔狭窄产生缺血性肾组织。这种类型高血压的发生率极低,无法根据所进行的随访检查来估计。这些检查显示高血压发生率在2.3%至3.8%之间,这可能是由原发性高血压的发展所解释。仅在28例病例报告中发现了永久性高血压与钝性肾损伤之间的确切关系。

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