CAJ | 학술논문

目的探讨显微血管减压术治疗神经性高血压的疗效. 方法自2009年9月到2011年6月间,采取显微血管减压术治疗脑神经疾病患者中36例术前伴有神经源性高血压.对12例合并有高血压的左侧脑神经疾病患者进行左侧延髓腹外侧区显微血管减压手术,术前及术后监测患者血压、血管紧张素A2、醛固酮水平,术后随访6～25个月,平均时间10个月.观察其血压恢复情况. 结果随访示患者高血压情况有较为明显的改善,行左侧延髓腹外侧区显微血管减压手术探查12例患者术后高血压治愈3例；显效5例；有效3例；无效1例.术后较术前血清血管紧张素、醛同酮均有降低,差异有统计学意义(P＜0.05).未行左侧延髓腹外侧区显微血管减压手术探查组24例术后高血压治愈3例；显效6例；有效8例；无效7例. 结论异常血管袢压迫脑神经根及延髓,长期疼痛刺激和情绪紧张是神经性高血压的病因之一,行左侧延髓腹外侧区的显微血管减压术可使神经源性高血压患者的血压下降.
목적 탐토현미혈관감압술치료신경성고혈압적료효. 방법 자2009년9월도2011년6월간,채취현미혈관감압술치료뇌신경질병환자중36례술전반유신경원성고혈압.대12례합병유고혈압적좌측뇌신경질병환자진행좌측연수복외측구현미혈관감압수술,술전급술후감측환자혈압、혈관긴장소A2、철고동수평,술후수방6～25개월,평균시간10개월.관찰기혈압회복정황. 결과 수방시환자고혈압정황유교위명현적개선,행좌측연수복외측구현미혈관감압수술탐사12례환자술후고혈압치유3례；현효5례；유효3례；무효1례.술후교술전혈청혈관긴장소、철동동균유강저,차이유통계학의의(P＜0.05).미행좌측연수복외측구현미혈관감압수술탐사조24례술후고혈압치유3례；현효6례；유효8례；무효7례. 결론 이상혈관번압박뇌신경근급연수,장기동통자격화정서긴장시신경성고혈압적병인지일,행좌측연수복외측구적현미혈관감압술가사신경원성고혈압환자적혈압하강.
Objective To investigate the effect of microvascular decompression (MVD) in patients with severe hypertension with microvascular comprssion(MVC) on blood pressure.Methods From September 2009 to June 2011,thirty-six cases of cranial nerve diseases who also suffered with primary hypertension before MVD operation,and 12 cases suffered with hypertension of the left cranial nerve disease received MVD operation on the left ventrolateral medulla.The BP and hormone levels of these cases were compared before and after the operation to evaluate the effective on BP of MVD,and to observed the BP levels in 6-25months.Results Twelve cases received MVD operation on the left ventrolateral medulla and the result showed:three cases were cured,five cases improved,three cases were effective,however,one cases were invalid.Levels of serum angiotensin A2 and aldosterone went down after the operation (P ＜ 0.05).Twenty-four cases did not receive MVD operation on the left ventrolateral medulla and the result showed:three cases were cured,six cases improved eight cases were effective,seven cases were invalid.Conclusion A more significant improvement in follow-up shown in patients with high blood pressure.It was pathogenesis of neurogenic hypertension that oppressing cranial nerve roots and the medulla oblongata by abnormal vascular loop leads to long term aching stimulation and emotional stress,MVD operation on the left ventrolateral medulla is an effective treatment of neurogenic hypertension.