高血壓患者福音 安南醫院完成首例「腎臟交感神經阻斷術」 治療難治型高血壓患者
2022-12-14 記者姚瑞／台南報導
安南醫院高血壓導管治療手術側拍。
安南醫院心臟內科年引進「腎臟交感神經阻斷術治療系統」（The Renal Denervation system, RDN）後，成功於上（11）月治療難治型高血壓患者。此項新一代導管治療無疑為高血壓患者之福音，除了能24小時全面控制高血壓，更有望協助患者擺脫終身服用降壓藥。
安南醫院心臟內科主任林志展表示，高血壓除了是現代常見慢性病，也是引發心血管疾病、腦中風、腎臟病最主要的危險因子。根據衛福部國民健康署統計，我國65歲以上民眾，超過六成患有高血壓，其中多數患者甚至需終身服用藥物，其嚴重性不容小覷。
安南醫院心臟內科主任林志展表示，高血壓是現代常見慢性病，也是引發心血管疾病、腦中風、腎臟病最主要的危險因子。
過去針對高血壓的治療分為非藥物（生活型態調整、飲食控制）及藥物治療，近年新一代導管治療則帶來突破性發展，不只能協助患者控制血壓甚至有機會不再持續服用降血壓藥物。
林志展主任說明，高血壓患者普遍有腎臟交感神經過度活躍的問題，導致血壓持續攀升並對心臟、腎臟及血管帶來傷害。所幸，透過腎臟交感神經阻斷術治療系統，可減低腎臟荷爾蒙分泌量、舒緩血壓，進而保護心臟、腎臟及血管免受進一步損害。
根據最新臨床數據顯示，腎臟交感神經阻斷術治療系統的特點包括︰24小時有效控制高血壓、療程安全且手術時間短，加上不需要全身麻醉，所以傷口小、恢復時間短，併發症亦相對輕微，還可促使患者收縮壓下降約10～40mmHg。此技術適用於用藥服從性低、服藥有副作用、已併發器官受損、難治型高血壓、次發性高血壓，且經治療後血壓仍不可控等類型患者。
林志展主任提及，高血壓導管治療屬於微創治療，流程大致為醫師先行安排鎮靜劑與止痛藥，協助患者放鬆、減低不適感；接著以打針方式，在患者動脈置入一條治療用導管，再將高頻率電波輸送至腎臟動脈壁上數個適合位置。此時，患者可能會感到下腹些微熱脹，不過維持時間短，必要時亦可加強止痛藥。
高血壓導管治療（圖片取自_高血壓導管治療衛教網）。
當一側腎動脈療程成功後，醫師會在另一側腎動脈重覆上述步驟，直至手術完成才會撤出患者體內所有導管器械。整體手術時間約為一小時，不僅隔天即可出院，術後恢復快、併發症少，數月即達持續控制血壓之目標。
如今，安南醫院已擁有腎臟交感神經阻斷術成功之經驗，林志展主任分享期許，冀望未來這項尖端技術能讓患者擁有不同選擇，方便與醫師共同討論出最佳治療方案，進而守護自身健康。
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