Kết quả điều trị tăng huyết áp sau phẫu thuật sửa hẹp eo động mạch chủ ở trẻ em tại Bệnh viện Nhi Trung ương

Abstract

The study aimed to describe the characteristics and treatment outcomes of paradoxical hypertension after surgery for aortic coarctation (CoA) at the National Children’s Hospital. This retrospective descriptive study included 89 patients diagnosed with hypertension after aortic coarctation surgery at the National Children's Hospital from June 2018 to June 2023. The study results showed that the percentage of paradoxical hypertension after surgery was 77.4%. The level of stage 2 hypertension accounted for 79.8%, mainly within the first 24 hours after surgery. 72.2% of patients with stage 1 hypertension were treated with one type of antihypertensive medication, while 74.6% of patients with stage 2 hypertension were treated with ≥ 2 types of antihypertensive medications (p < 0.05). Stage 2 hypertension patients (74.6%) and stage 1 hypertension patients (22.2%) (p < 0.05) were treated with contanous intravenous antihypertensive medication (Loxen). 76.4% of patients achieved a sub-hypertensive threshold after 5 days of treatment, while 23.6% continued to have sustained hypertension after 5 days of treatment. 23.8% of stage 2 hypertension patients still had sustained hypertension after 5 days of treatment. Conclusion: Paradoxical hypertension following surgical repair of CoA was a common complication, particularly within the first 24 hours after surgery, with a high prevalence of stage 2 hypertension. Most patients responded well to antihypertensive treatment; however, a notable proportion continued to experience persistent hypertension beyond 5 days of therapy. Loxen and Captopril had demonstrated efficacy and safety in the treatment; however, close monitoring of the clinical response and appropriate adjustments according to the patient's clinical course are necessary.