Jimu news reporter Liu Xun
Correspondent Wang Chen
The blood pressure of 2-year-old girl Lingling (pseudonym) soared to 158/103 mm Hg, comparable to that of a septuagenarian with high blood pressure. What's the problem? Experts from Wuhan Children's Hospital joined forces to find out the real culprit behind the scenes: the child's left kidney has an artery stenosis, resulting in kidney malnutrition and shrinkage, not only no kidney function but also high blood pressure. After the experts widened her blood vessels, her blood pressure looked back and her kidneys were saved. On January 18, Lingling was successfully discharged from the hospital.
The 2-year-old girl's blood pressure is abnormally high
Lingling is 2 years old this year, lively and cute. Last month, her attentive mother found that Lingling had a lot of bubbles to urinate after she got up in the morning. Although the child did not have other discomfort or abnormal manifestations, after several days of continuous observation, she still felt some uneasiness in her heart, so she took her daughter to Wuhan Children's Hospital for treatment.
As soon as the results of the examination came out, she was surprised. Lingling's blood pressure was unexpectedly explosive, with a high pressure of 158 mm Hg and a low pressure of 103 mm Hg. Mom exclaimed, "This is almost the same as the old man with high blood pressure at home!" Not only that, Lingling's proteinuria has four "+", and the two kidneys are not the same size. The doctor judged that the child was likely to have a severe kidney disease.
In the nephrology department of the hospital, Lingling became a small patient number that focused on the hospital. Director Wang Xiaowen led the team to trace the source step by step. After preliminary judgment, Lingling is likely to be high blood pressure caused by renal vascular problems. Experts have consulted with experts in ultrasound imaging, radiology, CT and magnetic resonance imaging and nuclear medicine.
The examination found that Lingling's left kidney is smaller than that of the right kidney, the left kidney function is only one-tenth of the right kidney, and the culprit that leads to hypertension is "the opening stenosis of the left kidney artery", which is only one-third of the normal channel for transporting nutrients to the kidneys, and the kidney lacks blood supply for a long time, resulting in impaired function, and the mother is anxious.
Starting from the purpose of kidney protection, Director Wang Xiaowen joined hands with experts from multiple disciplines to repeatedly discuss the examination results and formulate a treatment plan. Through the ultrasound examination, they were pleasantly surprised to find that this pathway still has blood flow through, the kidney elasticity is acceptable, and if the channel can be expanded, the shrunken "small" kidney can restore blood supply and possibly restore function.
Mini balloons widen the nutritional "pathway"
Subsequently, the radiology intervention team "took the baton" and found the narrow section of the renal blood vessel through angiography, and found that the beginning of the left renal artery was only 1.5 mm wide, and the kidney was atrophied and hardened due to insufficient blood supply. If this nutrient "delivery line" is widened through interventional surgery, this will be the treatment for the least damage to the child. But children are too small and the blood vessels are too fine, and even minimally invasive surgery will be at risk.
But Ms. Lee decided to give it a go. On January 14, experts from radiology, nephrology, ultrasound imaging, nuclear medicine and anesthesiology escorted Lingling. Because the blood vessels are too thin and the applicable balloons are rare, Liu Xinxian, deputy chief physician of the Department of Radiology, specifically found a balloon catheter with a diameter of 3 mm for her. Anesthesia is the first pass, anesthesiologists are ready, under the guidance of Director Huang Sui of the Radiography Department, Liu Xinxian and He Xiaojun control the interventional instruments to enter from the femoral artery, the operation is very gentle, so as not to damage the blood vessels, and rely on the accurate grasp of the vascular structure, bypassing the bend of the blood vessels reversing nearly 90 degrees, and then turning back into the narrow section, so that the balloon can successfully reach the narrow section.
Radiographians are operating on surgery
When the blood vessel is expanded, a little carelessness may lead to a tearing of the blood vessel, with years of feel, the expert dilates the balloon little by little, and finally the blood vessel expands to the ideal state, and the operation is successful. On the second day, Lingling's blood pressure dropped to 127/85 mmHg, on the third day her blood pressure dropped further to 101/50 mm Hg, and on the fourth day, her blood pressure was normal, her blood flow in the kidneys improved, and the "small" kidneys were significantly enlarged. On January 18, LingLing was successfully discharged from the hospital and returned home, and she needed to follow up regularly in the later stage.
Director Wang Xiaowen examined Lingling
Wang Xiaowen introduced, children's hypertension and adult hypertension is different, many are caused by kidney disease, although eating antihypertensive drugs can play a role in reducing blood pressure, but the treatment of symptoms is not the root cause, once found in children's hypertension, parents should be highly vigilant is a difficult disease, should go to the professional children's hospital to find the cause, develop a diagnosis and treatment plan.