Hypertensive syndrome

Hypertensive syndrome in surgery is viewed from several positions.

Arterial hypertension is important insofar as it can cause a number of vascular complications, both during the operation and after it: hemorrhages, ischemia, crises, etc. Establish a hypertensive syndrome by simply measuring blood pressure in the peripheral arteries. The surgeon is obliged to call for consultation of the therapist for its differential diagnosis and treatment. When preparing for surgery, an anesthesiologist performs her correction.

Pulmonary hypertension syndrome - increased blood pressure in a small circle of blood circulation. It is a secondary process that complicates the pulmonary, cardiac and diaphragm pathologies of various genesis: trauma, inflammatory diseases, degenerative processes, malformations, embolic complications, rapid and massive transfusion of fluids, etc. Clinically hypertensive syndrome is accompanied by bouts of causeless fever (chills, profuse sweat; especially at night) without a significant increase in body temperature; bouts of shortness of breath, cough with transient cyanosis; but the auscultative picture does not correspond to external manifestations; can develop pulmonary edema or hemoplethritis as a compensatory reaction, aimed at self-discharge of the small circle through the lymphatic system. On the part of the cardiovascular system, unstable blood pressure, tachycardia, sometimes with extrasystole, increase CVP above 12 cm of water. Art. The ECG shows signs of an overload of the right heart. The diagnosis is confirmed by radiography of the lungs: enlargement and consolidation of the pulmonary root, intensification of the pulmonary pattern against a background of general or uneven decrease in pneumonia of the lung tissue, the presence of Curley lines (small low-intensity horizontal lines from the root to the periphery of the lungs). Differential diagnosis and management of pulmonary hypertension is the competence of resuscitators.

Portal hypertension syndrome is a pathological condition caused by impaired circulation and increased pressure in the portal vein. Clinical manifestations, despite many reasons, are ultimately the same: the formation of splenomegaly, varicose veins of the esophagus and stomach with bleeding, ascites. This question was considered most fully by M.D. Patricia (1974). By the type of blockade portal hypertensive syndrome is divided into 4 types: superhepatic (heart disease with outcome in cirrhosis - Pick's disease, thrombosis of the hepatic veins - Chiari's disease, thrombosis, compression, stenosis of the inferior vena cava, Badda-Chiari disease); intrahepatic (cirrhosis, fibrosis, liver tumors, dysplasia, polycystosis); extrahepatic (disturbance of blood flow in the portal vein due to fibrosis, thrombosis, stenosis, compression); mixed. The blood flow can be in a state of compensation, subcompensation and decompensation. In 70% of cases, portal hypertension is caused by cirrhosis of the liver. Complete diagnosis is possible only in a surgical hospital.

Organ and cavitary hypertensive syndrome is caused either by the violation of the passage of biological fluids and gases along hollow organs or ducts with their expansion, sometimes with the formation of pseudocysts (hydronephrosis, intestinal obstruction, cystic hypoplasia of the liver, lungs, etc.), or with compression of the organ in the serous cavity pneumothorax, compression of the brain, cardiac tamponade, etc.).

[1], [2]