Cooper T J, Clutton-Brock T H, Jones S N, Tinker J, Treasure T
Br Heart J. 1985 Jul;54(1):91-5. doi: 10.1136/hrt.54.1.91.
Paroxysmal hypertension after cardiac surgery is a phenomenon of physiological and clinical significance. The possible preoperative and intraoperative factors that may predict its occurrence were studied in 81 consecutive patients undergoing coronary artery surgery (n = 58) or valve replacement (n = 27), of whom 45 (56%) developed postoperative hypertension. Hypertension occurred significantly more often in those patients who received beta adrenergic blocking agents preoperatively and who underwent coronary artery surgery. Patients with hypertension had significantly higher mean left ventricular ejection fractions preoperatively (52%) than those without (41%) and required phentolamine significantly more often and isoprenaline significantly less often intraoperatively. It is suggested that the significance of preoperative beta adrenergic blockade, the type of operation, and the intraoperative requirement for phentolamine in patients who developed post-operative hypertension may indicate the role of enhanced sympathetic activity and disturbance of cardiac receptors during surgery. Preoperative myocardial performance and the method of myocardial protection during surgery are likely to influence the occurrence of the hypertensive phenomenon.
心脏手术后的阵发性高血压是一种具有生理和临床意义的现象。在81例连续接受冠状动脉手术（n = 58）或瓣膜置换术（n = 27）的患者中，研究了可能预测其发生的术前和术中因素，其中45例（56%）出现术后高血压。术前接受β肾上腺素能阻滞剂治疗且接受冠状动脉手术的患者中，高血压的发生率明显更高。高血压患者术前平均左心室射血分数（52%）明显高于无高血压患者（41%），术中使用酚妥拉明的频率明显更高，而异丙肾上腺素的使用频率明显更低。提示术前β肾上腺素能阻滞剂的使用、手术类型以及术后高血压患者术中对酚妥拉明的需求，可能表明手术期间交感神经活动增强和心脏受体紊乱所起的作用。术前心肌功能和手术期间心肌保护方法可能会影响高血压现象的发生。
