Kawamura J, Higashi Y, Okada Y, Yoshida O, Ishikawa K, Hara A, Kumata K
Hinyokika Kiyo. 1983 Jan;29(1):1-8.
Based on the retrospective analysis of 38 cases of renovascular hypertension treated by surgical intervention, the following indications are proposed for arterial reconstructive surgery: younger age of patient, short duration of hypertension, renin-mediated hypertension and extent and functional significance of the obstructing arterial lesion, favorable level of renal function in the affected side, and renal function threatened by advanced progressive vascular disease, surgically correctable lesion, and focal, unilateral renal arterial atherosclerosis without generalized atherosclerosis, good surgical risk, and hypertension not responding to medical treatment. Although the clinical use of the angiotensin I converting enzyme inhibitor and induction of percutaneous transluminal angioplasty can provide a new approach to non-surgical treatment for renovascular hypertension, the long-term use of antihypertensive drugs induces gradual decrease in renal function. Surgical treatment is best reserved for the patient on whom the available data meet the above criteria for vascular surgery.
基于对38例接受外科手术干预治疗的肾血管性高血压患者的回顾性分析，提出动脉重建手术的以下适应证：患者年龄较轻、高血压病程较短、肾素介导的高血压、阻塞性动脉病变的范围及功能意义、患侧肾功能处于良好水平、肾功能受到进展性晚期血管疾病的威胁、可通过手术矫正的病变、局灶性单侧肾动脉粥样硬化而非全身性动脉粥样硬化、良好的手术风险以及对药物治疗无反应的高血压。虽然血管紧张素I转换酶抑制剂的临床应用和经皮腔内血管成形术的实施可为肾血管性高血压的非手术治疗提供新途径，但长期使用抗高血压药物会导致肾功能逐渐下降。手术治疗最好留给那些现有数据符合上述血管手术标准的患者。
