• 1.中國航空工業(yè)中心醫(yī)院血管外科(北京 100012);;
  • 2.首都醫(yī)科大學血管外科研究所(北京 100053);;
  • 3.第二炮兵總醫(yī)院心胸血管外科(北京 100088);

目的  探討大動脈炎所致腎動脈上腹主動脈閉塞的手術(shù)治療方法。方法  回顧性分析1例腎動脈上腹主動脈閉塞行腹主動脈-雙股動脈人工血管搭橋手術(shù)治療的患者的臨床資料,并進行文獻復習。結(jié)果  術(shù)后患者頭痛明顯好轉(zhuǎn)，血壓由術(shù)前的220/110 mm Hg(1 mm Hg=0.133 kPa)降至160/100 mm Hg,雙下肢踝肱指數(shù)由0.50升至1.19。術(shù)后2周復查CTA示人工血管通暢，術(shù)后3個月復查彩超示人工血管通暢，血壓在(140～150)/(80～95) mm Hg間波動，雙眼視力1.0左右，已恢復正常生活。結(jié)論  大動脈炎所致腎動脈上腹主動脈閉塞常會影響多個重要臟器的供血，病變復雜，手術(shù)時機及方法的正確選擇及長期抗炎治療可以提高患者的治療效果。

引用本文： 李震,汪忠鎬,王雷永,霍小森,卞策. 大動脈炎致腎動脈上腹主動脈閉塞的手術(shù)治療. 中國普外基礎與臨床雜志, 2010, 17(6): 613-614. doi: 復制

1. 中華醫(yī)學會風濕病學分會. 大動脈炎診治指南(草案) [J]. 中華風濕病學雜志， 2004； 8(8)： 502-504.
2. 苑超, 吳慶華, 王仕華, 等. 手術(shù)治療近腎動脈腹主動脈閉塞癥 [J]. 中華外科雜志， 1996； 34（7）： 388-390.
3. 劉永民， 孫立忠， 胡盛壽， 等. 大動脈炎外科治療的經(jīng)驗和新進展（附236例報告） [J]. 中國醫(yī)刊， 2004； 39（8）： 27-29.
4. Ryan SV, Calligaro KD, McAffee-Bennett S, et al. Management of juxtarenal aortic aneurysms and occlusive disease with preferential suprarenal clamping via a midline transperitoneal incision: technique and results [J]. Vasc Endovascular Surg, 2004; 38(5): 417-422.
5. Walsh SR, Boyle JR, Lynch AG, et al. Suprarenal endograft fixation and medium-term renal function: systematic review and meta-analysis [J]. J Vasc Surg, 2008; 47(6): 1364-1370.
6. Rigberg D, Jimenez JC, Lawrence P, et al. A combined endovascular and open “reverse hybrid” technique for repair of complex juxtarenal inflammatory aortic aneurysms [J]. Vasc Endovascular Surg, 2009; 43(5): 494-496.
7. Yeung KK, Jongkind V, Coveliers HM, et al. Routine continuous cold perfusion of the kidneys during elective juxtarenal aortic aneurysm repair [J]. Eur J Vasc Endovasc Surg, 2008; 35(4): 446-451.
8. Yeung KK, Tangelder GJ, Fung WY, et al. Open surgical repair of ruptured juxtarenal aortic aneurysms with and without renal cooling: observations regarding morbidity and mortality [J]. J Vasc Surg, 2010; 51(3): 551-558.
9. Kksal C, Sarikaya S, Zengin M. Thoracofemoral bypass for treatment of juxtarenal aortic occlusion[J]. Asian Cardiovasc Thorac Ann, 2002; 10(2): 141-144.
10. Pearce JD, Edwards MS, Stafford JM, et al. Open repair of aortic aneurysms involving the renal vessels [J]. Ann Vasc Surg, 2007; 21(6): 676-686.
11. Patel R, Conrad MF, Paruchuri V, et al. Balloon expandable st-ents facilitate right renal artery reconstruction during complex open aortic aneurysm repair [J]. J Vasc Surg, 2010; 51(2): 310-315.
12. 符偉國， 吳元兵. 腎動脈狹窄的腔內(nèi)治療 [J]. 中國普外基礎與臨床雜志， 2006; 13（6）： 634-635.
13. Krauss T, Pfammatter T, Mayer D, et al. Hybrid-repair of thoraco-abdominal or juxtarenal aortic aneurysm: what the radiologist should know [J]. Eur Radiol, 2010; 20(4): 1011-1022.
14. Nordon IM, Hinchliffe RJ, Holt PJ, et al. Modern treatment of juxtarenal abdominal aortic aneurysms with fenestrated endografting and open repair-a systematic review [J]. Eur J Vasc Endovasc Surg, 2009; 38(1): 35-41.
15. van de Mortel RH, Vahl AC, Balm R, et al. Collective experience with hybrid procedures for suprarenal and thoracoabdominal aneurysms[J]. Vascular, 2008; 16(3): 140-146.
  1. 1. 中華醫(yī)學會風濕病學分會. 大動脈炎診治指南(草案) [J]. 中華風濕病學雜志， 2004； 8(8)： 502-504.
  2. 2. 苑超, 吳慶華, 王仕華, 等. 手術(shù)治療近腎動脈腹主動脈閉塞癥 [J]. 中華外科雜志， 1996； 34（7）： 388-390.
  3. 3. 劉永民， 孫立忠， 胡盛壽， 等. 大動脈炎外科治療的經(jīng)驗和新進展（附236例報告） [J]. 中國醫(yī)刊， 2004； 39（8）： 27-29.
  4. 4. Ryan SV, Calligaro KD, McAffee-Bennett S, et al. Management of juxtarenal aortic aneurysms and occlusive disease with preferential suprarenal clamping via a midline transperitoneal incision: technique and results [J]. Vasc Endovascular Surg, 2004; 38(5): 417-422.
  5. 5. Walsh SR, Boyle JR, Lynch AG, et al. Suprarenal endograft fixation and medium-term renal function: systematic review and meta-analysis [J]. J Vasc Surg, 2008; 47(6): 1364-1370.
  6. 6. Rigberg D, Jimenez JC, Lawrence P, et al. A combined endovascular and open “reverse hybrid” technique for repair of complex juxtarenal inflammatory aortic aneurysms [J]. Vasc Endovascular Surg, 2009; 43(5): 494-496.
  7. 7. Yeung KK, Jongkind V, Coveliers HM, et al. Routine continuous cold perfusion of the kidneys during elective juxtarenal aortic aneurysm repair [J]. Eur J Vasc Endovasc Surg, 2008; 35(4): 446-451.
  8. 8. Yeung KK, Tangelder GJ, Fung WY, et al. Open surgical repair of ruptured juxtarenal aortic aneurysms with and without renal cooling: observations regarding morbidity and mortality [J]. J Vasc Surg, 2010; 51(3): 551-558.
  9. 9. Kksal C, Sarikaya S, Zengin M. Thoracofemoral bypass for treatment of juxtarenal aortic occlusion[J]. Asian Cardiovasc Thorac Ann, 2002; 10(2): 141-144.
  10. 10. Pearce JD, Edwards MS, Stafford JM, et al. Open repair of aortic aneurysms involving the renal vessels [J]. Ann Vasc Surg, 2007; 21(6): 676-686.
  11. 11. Patel R, Conrad MF, Paruchuri V, et al. Balloon expandable st-ents facilitate right renal artery reconstruction during complex open aortic aneurysm repair [J]. J Vasc Surg, 2010; 51(2): 310-315.
  12. 12. 符偉國， 吳元兵. 腎動脈狹窄的腔內(nèi)治療 [J]. 中國普外基礎與臨床雜志， 2006; 13（6）： 634-635.
  13. 13. Krauss T, Pfammatter T, Mayer D, et al. Hybrid-repair of thoraco-abdominal or juxtarenal aortic aneurysm: what the radiologist should know [J]. Eur Radiol, 2010; 20(4): 1011-1022.
  14. 14. Nordon IM, Hinchliffe RJ, Holt PJ, et al. Modern treatment of juxtarenal abdominal aortic aneurysms with fenestrated endografting and open repair-a systematic review [J]. Eur J Vasc Endovasc Surg, 2009; 38(1): 35-41.
  15. 15. van de Mortel RH, Vahl AC, Balm R, et al. Collective experience with hybrid procedures for suprarenal and thoracoabdominal aneurysms[J]. Vascular, 2008; 16(3): 140-146.