子どもにおける血管新生高血圧
Kjell Tullus1, Eileen Brennan, George Hamilton
1Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Trust, London, UK. tulluk@gosh.nhs.uk
Lancet (London, England)
|April 29, 2008
まとめ
腎血管疾患は,小児高血圧の珍しい原因であり,しばしば診断の遅れに直面します. 血管内部の処置や手術を含む迅速な介入は,子供の高血圧を効果的に管理することができます.
科学分野:
- 小児腎臓病理学について
- 血管医学 血管医学とは
- 心臓病学 心臓病学
背景:
- 腎血管疾患は,小児における高血圧の珍しいが重要な原因である.
- 遅れた診断は,血圧のモニタリングの頻度が少ないことと小児患者の高い値の解雇により頻繁に起こります.
- 他の主要な血管の関連異常は,腎血管疾患の子どもではよく見られる.
研究 の 目的:
- 子どもの腎血管疾患の診断と治療のアプローチを要約する.
- 早期発見と多学科的な管理の重要性を強調する.
- 現在の治療方法の有効性を検討する.
主な方法:
- CT,MRI,およびアンジオテンシン変換酵素阻害による腎スシンチグラフィを含む診断画像技術のレビュー.
- アンジオグラフィーは,診断の黄金基準です.
- 介入的および外科的治療オプションの議論.
主要な成果:
- ステント付きまたはステントなしの内血管治療は,罹患児の50%以上で高血圧を治すまたは減らすのに成功しています.
- 必要に応じて外科的介入が推奨され,理想的には骨格の成熟まで延期されます.
- 多学問的なチームマネジメントは,長期的に有利な結果をもたらします.
結論:
- 早期の認識と早期の介入は,小児腎血管高血圧の管理に不可欠です.
- 血管内科治療と外科治療の両方とも,大きな利点があります.
- 小児腎臓科医,介入放射線科医,血管外科医を含む共同アプローチは,長期的な結果を最適化します.
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