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患有基础肾脏疾病的高血压危象患者的管理:病例报告。

Management of hypertensive crisis in a patient with underlying kidney disease: A case report.

机构信息

University of California, Santa Cruz, United States.

Igbinedion University Okada, Benin City, Nigeria.

出版信息

Medicine (Baltimore). 2023 Nov 17;102(46):e36152. doi: 10.1097/MD.0000000000036152.

Abstract

RATIONALE

This case report elucidates the management of a hypertensive crisis in a patient with underlying kidney disease, shedding light on the intricate interplay between these conditions. This unique case contributes valuable insights to the scientific literature.

PATIENT CONCERNS

The patient exhibited severe headache, visual disturbances, and chest pain. Clinical evaluation revealed elevated blood pressure and impaired kidney function, emphasizing the importance of monitoring hypertension and renal health in such cases.

DIAGNOSES AND INTERVENTIONS

The primary diagnoses included malignant hypertension and underlying kidney disease. Immediate interventions comprised intravenous antihypertensive agents and rigorous hemodynamic monitoring, yielding favorable outcomes. Blood pressure gradually returned to acceptable levels, and renal function improved during treatment.

CONCLUSIONS

This case underscores the critical need for timely recognition and management of hypertensive crises in patients with preexisting kidney dysfunction. Simultaneously addressing both conditions is vital for successful outcomes. Healthcare practitioners must remain vigilant in assessing the intricate relationship between hypertension and kidney disease, employing tailored interventions for optimal results.

LESSON LEARNED

The primary lesson from this case is the necessity of a comprehensive approach to managing hypertensive crises in individuals with underlying kidney disease. Early intervention and a multidisciplinary strategy are essential to achieve positive clinical outcomes and prevent potential complications.

摘要

背景

本病例报告阐明了基础肾脏疾病患者高血压危象的管理方法,揭示了这些疾病之间错综复杂的相互关系。这一独特的病例为科学文献提供了有价值的见解。

患者关注点

患者表现出严重的头痛、视力障碍和胸痛。临床评估显示血压升高和肾功能受损,强调在这种情况下监测高血压和肾脏健康的重要性。

诊断和干预

主要诊断包括恶性高血压和基础肾脏疾病。立即进行了静脉内降压药物治疗和严格的血流动力学监测,取得了良好的结果。血压逐渐恢复到可接受的水平,治疗期间肾功能得到改善。

结论

本病例强调了在已有肾功能障碍的患者中及时识别和处理高血压危象的重要性。同时处理这两种疾病对于获得良好的结果至关重要。医疗保健从业者必须保持警惕,评估高血压和肾脏疾病之间的复杂关系,采用针对性的干预措施以获得最佳结果。

经验教训

从这个病例中得到的主要教训是,在有基础肾脏疾病的个体中,需要综合方法来管理高血压危象。早期干预和多学科策略对于实现良好的临床结果和预防潜在并发症至关重要。

相似文献

3
Hypertensive emergencies.高血压急症
Am Fam Physician. 1980 Mar;21(3):141-6.
6
Therapeutic survey: hypertensive emergencies.
Can J Cardiol. 1987 May;3(4):154-61.
7
Management of hypertensive crises.高血压急症的管理
Am J Ther. 2007 Mar-Apr;14(2):135-9. doi: 10.1097/01.pap.0000249908.55361.de.
8
[Hypertensive crises].
Acta Med Port. 1995 Dec;8(12):685-90.

引用本文的文献

1
Dependable approaches to hypertension management: A review.可靠的高血压管理方法:综述。
Medicine (Baltimore). 2024 Jun 14;103(24):e38560. doi: 10.1097/MD.0000000000038560.

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