Báo cáo ca lâm sàng: Góp phần kiểm soát huyết áp ở người bệnh tăng huyết áp kháng trị/suy thận, thận nhân tạo chu kì bằng nút tắc động mạch thận mất chức năng tại BVĐK Tâm Anh Hà Nội=Renal artery embolization in chronic renal failure for control hypertension resistant

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Đức Thăng Hoàng, Xuân Hiền Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.22-25

Bộ sưu tập: Metadata

ID: 243931

Thêm vào giỏ

Báo cáo một trường hợp nút tắc động mạch thận mất chức năng hai bên để kiểm soát tăng huyết áp kháng trị ở bệnh nhân suy thận, thận nhân tạo chu kì. Bệnh nhân nữ 26 tuổi, phát hiện suy thận và chạy thận nhân tạo từ năm 2014. Bệnh nhân đã được ghép thận năm 2016, đến năm 2018 xuất hiện thải ghép. Năm 2020, bắt đầu tăng huyết áp, ngày càng tăng và đáp ứng kém với điều trị. Năm 2022 người bệnh đã được đốt hạch thần kinh giao cảm điều trị tăng huyết áp nhưng không hiệu quả. Tháng 04/2024 bệnh nhân đã được phẫu thuật lấy bỏ thận ghép. Từ cuối năm 2023 đến tháng 05/2024 bệnh nhân phải dùng 05 loại thuốc hạ huyết áp, uống thuốc 08 lần/ ngày, HATT thường xuyên ở mức 200- 250mmHg. Bệnh nhân đã được can thiệp nút tắc động mạch thận mất chức năng hai bên ngày 29/05/2024 tại BVĐK Tâm Anh Hà Nội. Hiện tại, sau 06 tuần nút mạch, huyết áp trung bình trong ngày của người bệnh là 130/80mmHg, liều thuốc huyết áp giảm một nửa so với trước can thiệp.We report a case of bilateral renal artery embolization of nonfunction kidney to control the drug resistant persistent hypertension in a patient with end stage renal disease. A-26 years old women with renal failure and has been on hemodialysia since 2014. Renal transplantation was perfomed at 2016, but two years later appeared graft intolerance syndrome. Since 2020, the patient has appeared hypertetion, which was increasing and responding poorly to treatment. A radiofrequency ablation of the renal sympathetic nerves was perfomes at 2022, but hypertention condiction uncontrol. April 2024, a graft nephrectomy was perfomed. From the end of 2023 to May 2024, the patient must take 5 types of drugs treating hypertention, and take them 8 times per day, her SBP was 200-250mmHg. Patient was performed renal artery embolization at Ha Noi Tam Anh general hospital on 29May-2024. Currently, after 6 weeks of embolization, the patient’s average daily blood pressure is 130/80 mmHg and the dose of drugs treating hypertension reduced by half compared to before embolization.

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