Schreiber R, Augustin D, Schumacher G, Peters D, Bühlmeyer K
Klin Padiatr. 1986 Jul-Aug;198(4):326-9. doi: 10.1055/s-2008-1033881.
In the period from 1974 to 1983, altogether 234 children underwent surgery of isolated coarctation of the aorta at the Heart Center Munich. In 146 of these patients, a reactive increase of blood pressure has been noted following surgery, and in about half of them the blood pressure was considerably elevated above the 95-percentile. Since the success of surgery may be endangered by a critical increase of blood pressure, in 66 patients an antihypertensive therapy with clonidine has been started immediately after operation. By this treatment the intended decrease of blood pressure has been effected within the first two days after surgery, and in 91% of the patients the therapy could be stopped within the first two postoperative weeks. In 6 out of these 66 patients, the "paradoxical hypertension" persisted so that the clonidine therapy had to be continued after discharge from hospital. The empirically determined dosage and the duration of treatment have been modified by the clinical requirements, i.e. by the actual level of the blood pressure. The average duration of drug administration has been lengthened according to the advanced age at time of surgery, while the required clonidine dosage simultaneously showed a tendency to decrease. Since no side-effects have been registered in the course of this procedure, the use of clonidine suggests a promising therapeutical approach to "paradoxical hypertension".
在1974年至1983年期间，共有234名儿童在慕尼黑心脏中心接受了单纯主动脉缩窄手术。在这些患者中，有146名术后出现血压反应性升高，其中约一半患者的血压显著高于第95百分位数。由于血压的严重升高可能危及手术成功，66例患者术后立即开始使用可乐定进行抗高血压治疗。通过这种治疗，术后前两天内实现了预期的血压下降，91%的患者在术后两周内可以停止治疗。在这66例患者中，有6例“反常性高血压”持续存在，因此出院后必须继续使用可乐定治疗。根据临床需求，即根据实际血压水平，对经验性确定的剂量和治疗持续时间进行了调整。给药的平均持续时间根据手术时的年龄增长而延长，而所需的可乐定剂量同时呈现出下降趋势。由于在此过程中未记录到副作用，可乐定的使用提示了一种治疗“反常性高血压”的有前景的治疗方法。
