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肾动脉交感神经射频消融治疗继发性高血压的临床疗效。

Clinical Effect of Renal Arterial Sympathetic Radiofrequency Ablation on Secondary Hypertension.

机构信息

Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.

Department of Internal Medicine, Daji Street Health Center, Caidian District, Wuhan 430113, China.

出版信息

Comput Math Methods Med. 2022 Aug 1;2022:9948057. doi: 10.1155/2022/9948057. eCollection 2022.

Abstract

Sympathetic hyperactivity is one of the main mechanisms of secondary hypertension. Reducing renal sympathetic activity through surgery can effectively reduce blood pressure. Many cases have shown that renal denervation (RDN) can selectively block renal artery sympathetic nerve activity to control refractory hypertension. This surgery is a minimally invasive surgery, and the risk of surgery-related adverse events is significantly reduced compared with surgery. Therefore, the purpose of this study is to explore the efficacy of radiofrequency ablation of renal artery sympathetic nerve in the treatment of secondary hypertension. Eight patients with secondary hypertension diagnosed by the cardiovascular department of our hospital and treated with RDN were followed up for 3-18 months, of which 5 cases were followed up for more than 12 months and 8 cases were followed up for more than 3 months. Eight patients were treated with radiofrequency ablation of renal artery catheter. The parameters such as preoperative blood pressure, antihypertensive drugs, organ function, intraoperative ablation resistance, power, time, and temperature were determined. The related changes of blood pressure, antihypertensive drugs, and visceral function and the occurrence of side effects at 1 week and 1, 3, 6, and 12 months after operation were related to the operation. In conclusion, RDN has a significant clinical effect in the treatment of refractory hypertension, with stable postoperative blood pressure drop, reduced drug dosage, and less side effects.

摘要

交感神经活性亢进是继发性高血压的主要机制之一。通过手术降低肾交感神经活性可以有效降低血压。许多病例表明,肾去神经术(RDN)可以选择性地阻断肾动脉交感神经活性,从而控制难治性高血压。这种手术是一种微创手术,与手术相关的不良事件风险明显降低。因此,本研究旨在探讨射频消融肾动脉交感神经治疗继发性高血压的疗效。我院心血管科诊断为继发性高血压并接受 RDN 治疗的 8 例患者,随访 3-18 个月,其中 5 例随访超过 12 个月,8 例随访超过 3 个月。8 例患者采用经导管射频消融肾动脉术。确定术前血压、降压药物、器官功能、术中消融阻力、功率、时间和温度等参数。与手术相关的血压、降压药物和内脏功能的相关变化以及术后 1 周、1、3、6 和 12 个月的副作用发生情况。总之,RDN 治疗难治性高血压具有显著的临床效果,术后血压下降稳定,药物剂量减少,副作用较少。

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Update on Renal Sympathetic Denervation for the Treatment of Hypertension.高血压的治疗:肾脏去神经术的最新进展。
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