Popp M B, Friedberg D L, MacMillan B G
Ann Surg. 1980 Apr;191(4):473-8. doi: 10.1097/00000658-198004000-00014.
Although systemic arterial hypertension has been recognized as a common complication of thermal injury in children, its clinical characteristics have not been defined. This review of 987 burned children, treated over an 11-year period, documents development of hypertension in 195 patients (19.8%). The problem occurs most frequently in males and in the 7--10-year age group, but does not correlate with racial origin. Incidence increases with burn severity up to a 40% total surface burn. The incidence did not vary with the year of treatment when changes in patient population were eliminated. Fifteen of the 195 patients had hypertensive encephalopathy and seizure problems. No other complication or change in mortality could be related to hypertension. The problem could not be related to location of the burn wound, drug treatment, or differences in transfusion and fluid therapy. Comparison of the highest daily blood pressure measurements between matched hypertensive and normotensive groups demonstrated that the hypertensive and normotensive groups demonstrated that the hypertension is limited to the acute phase of burn wound treatment and that blood pressures are normal after complete autografting. The encephalopathy and seizure problems indicate the need for careful blood pressure monitoring and effective antihypertensive therapy in the treatment of burned children.
尽管系统性动脉高血压已被公认为儿童热损伤的常见并发症，但其临床特征尚未明确。本综述对11年间接受治疗的987名烧伤儿童进行了研究，记录了195名患者（19.8%）出现高血压的情况。该问题在男性和7至10岁年龄组中最为常见，但与种族无关。发病率随烧伤严重程度增加，直至全身表面积烧伤达40%。在排除患者群体变化的影响后，发病率并未随治疗年份而变化。195名患者中有15名出现高血压脑病和癫痫问题。没有其他并发症或死亡率变化与高血压相关。该问题与烧伤创面位置、药物治疗或输血及液体疗法的差异无关。对匹配的高血压组和血压正常组的每日最高血压测量值进行比较表明，高血压仅限于烧伤创面治疗的急性期，在完全自体植皮后血压恢复正常。脑病和癫痫问题表明，在治疗烧伤儿童时需要仔细监测血压并进行有效的抗高血压治疗。
