高血压性肾病作为肾癌的单侧肾切除术的起源
- 作者: Titjaev I.1, Andreev S.1,2, Andreeva S.1, Udalov K.1,2, Kas’janov D.1
-
隶属关系:
- City Clinical Hospital No. 1
- Novosibirsk State Medical University of the Ministry of Healthcare of the Russian Federation
- 期: 卷 10, 编号 3 (2020)
- 页面: 229-234
- 栏目: Original articles
- URL: https://journals.rcsi.science/uroved/article/view/42529
- DOI: https://doi.org/10.17816/uroved42529
- ID: 42529
如何引用文章
详细
目的:研究肾切开术后单肾结构功能变化的适应机制。
材料与方法。肾癌患者接受了两种类型的179项外科手术:肾切除术和肾脏切除术。手术后期间,进行了超声波检查,对单侧肾血管的大小和多普勒进行了评估,对操作中的病人进行了血压监测。
结果与讨论。肾脏切除的情况下,保留了控制功能组织体积的自适应机制。器官的负担仍然是最低的,生理上的,没有重新分配。血压不变。肾切除术并没有导致单一肾功能的变化,而是由于等离子体压力升高而造成的适应-病理结构的损害,“重新启动”器官,其代偿性肥大,伴随着静脉水肿对组织的压力因素,动脉张力升高,发展二次器官缺血,循环缺氧和血压升高。所有这些都适合高血压肾病。
结论。与保乳手术后的患者相比,接受肾切除术的患者发生动脉高压和高血压性肾病的潜在风险明显更高。老年人动脉高血压的最重要表现之一是侵犯“目标器官”的结构和功能,这些器官包括大脑,心脏,血管和肾脏。肾切除术形成病理性恶性循环,有助于肾脏和心血管衰竭的发展和进一步发展
作者简介
Igor Titjaev
City Clinical Hospital No. 1
Email: den-sk@ya.ru
Doctor of Medical Science, Professor, Urologist of Urology Department
俄罗斯联邦, NovosibirskSergey Andreev
City Clinical Hospital No. 1; Novosibirsk State Medical University of the Ministry of Healthcare of the Russian Federation
编辑信件的主要联系方式.
Email: andreev723@ya.ru
Head of Urology Department; Assistant of Department of Urology
俄罗斯联邦, NovosibirskSvetlana Andreeva
City Clinical Hospital No. 1
Email: andreev723@ya.ru
Head of the Department of Ultrasound Diagnostics
俄罗斯联邦, NovosibirskKonstantin Udalov
City Clinical Hospital No. 1; Novosibirsk State Medical University of the Ministry of Healthcare of the Russian Federation
Email: k.udalov@mail.ru
Head of Oncourology Department; Assistant of Department of Urology
俄罗斯联邦, NovosibirskDenis Kas’janov
City Clinical Hospital No. 1
Email: kasyanovds@mail.ru
Urologist, Oncologist of the Outpatient Care Center
俄罗斯联邦, Novosibirsk参考
- Лоран О.Б. Онкоурология сегодня: проблемы и достижения // Медицинский вестник. – 2007. – № 13. – С. 7–8. [Loran OB. Onkourologiya segodnya: problemy i dostizheniya. Meditsinskiy vestnik. 2007;(13):7-8. (In Russ.)]
- Давыдов М.И., Аксель Е.М. Заболеваемость злокачественными новообразованиями населения России и стран СНГ в 2008 г. // Вестник РОНЦ им. Н.Н. Блохина РАМН. – 2010. – Т. 21. – № 2S1. – С. 52–86. [Davydov MI, Aksel’ EM. Zabolevaemost’ zlokachestvennymi novoobrazovaniyami naseleniya Rossii i stran SNG v 2008 g. Herald of N.N. Blokhin Cancer Research Center RAMS. 2010;21(2 S1):52-86. (In Russ.)]
- Алексеев Б.Я., Анжиганова Ю.В., Лыков А.В., и др. Особенности диагностики и лечения рака почки в России: предварительные результаты многоцентрового кооперированного исследования // Онкоурология. – 2012. – № 3. – С. 24–31. [Alekseev BYa, Anzhiganova YuV, Lykov AV, et. al. Some specific features of the diagnosis and treatment of kidney cancer in Russia: preliminary results of a multicenter cooperative study. Cancer Urology. 2012;8(3):24-30. (In Russ.)]. https://doi.org/10.17650/1726-9776-2012-8-3-24-30.
- Keane T, Gillatt D, Evans CP, et al. Current and future trends in the treatment of renal cancer. European Urology Supplements. 2007;6(3):374-384. https://doi.org/10.1016/j.eursup.2006.12.006.
- Sun M, Bianchi M, Trinh QD, et al. Comparison of partial vs radical nephrectomy with regard to other cause mortality in T1 renal cell carcinoma among patients aged ≥75 years with multiple comorbidities. BJU Int. 2013;111(1):67-73. https://doi.org/10.1111/j.1464-410X.2012.11254.x.
- Van Biesen W, Vanhotder R, Lameire N. Determination of acute renal failure: Small and beyond. Clin J Am Soc Nephrol. 2006;1:1314-1319.
- Смирнов А.В., Добронравов В.А., Бодур-Ооржак А.Ш., и др. Эпидемиология и факторы риска хронических болезней почек: региональный уровень общей проблемы // Терапевтический архив. – 2005. – Т. 77. – № 6. – С. 20–27. [Smirnov AV, Dobronravov VA, Bodur-Oorzhak AS, et al. Epidemiology and risk factors of chronic renal diseases: a regional level of the problem. Ter Arkh. 2005;77(6):20-27. (In Russ.)]
- Смирнов А.В., Добронравов В.А., Каюков И.Г. Кардио-ренальный континуум: патогенетические основы превентивной нефрологии // Нефрология. – 2005. – Т. 9. – № 3. – С. 7–15. [Smirnov AV, Dobronravov VA, Kayukov IG. Cardiorenal continuum, pathogenetic grounds of preventive nephrology. Nephrology (Saint Petersburg). 2005;9(3):7-15. (In Russ.)] https://doi.org/10.24884/1561-6274-2005-9-3-7-15.
- Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296-1305. https://doi.org/10. 1056/NEJMoa041031.
- Campbell SC, Novick AC, Belldegrun A, et al. Guideline for management of the clinical T1 renal mass. J Urol. 2009;182(4):1271-1279. https://doi.org/10.1016/j.juro.2009.07.004.
- Дементьева И.И., Чарная М.А., Морозов Ю.А. Патология системы гемостаза: руководство. – М.: ГЭОТАР-Медиа, 2011. – 288 с. [Dement’eva II, Charnaya MA, Morozov YuA. Patologiya sistemy gemostaza: rukovodstvo. Мoscow: GEOTAR-Media; 2011. 288 p. (In Russ.)]
- Есаян А.М., Аль-Шукри С.Х., Мосоян М.С. Почечно-клеточный рак и хроническая болезнь почек: внимание к отдаленным неонкологическим исходам // Нефрология. – 2012. – Т. 16. – № 4. – С. 94–99. [Yesayan AM, Al-Shukri SKh, Mosoyan MS. Renal cell carcinoma and chronic kidney disease: attention to remote non-cancer outcomes. Nephrology (Saint Petersburg). 2012;16(4):94-99 (In Russ.)] https://doi.org/10.24884/1561-6274-2012-16-4-94-99.
- Балуда В.П., Балуда М.В., Тлепшуков И.К., Цыб А.Ф. Рак и тромбозы. – Москва – Обнинск, 2001. – 153 с. [Baluda VP, Baluda MV, Tlepshukov IK, Tsyb AF. Rak i trombozy. Moscow – Obninsk, 2001. 153 p. (In Russ.)]