Abstract:

Objective This study aimed to explore the effect of intraoperative different blood pressure management on early acute kidney injury in elderly patients undergoing major abdominal surgery. Methods A total of 164 patients with elective major abdominal surgery were selected and randomly divided into two groups ： standardized management group（group S，n = 82，MAP was no less than 65 mmHg or 80% of the basic value） and individualized management group（group I，n = 82，MAP regulation was in the range of 90% ~ 110% of the basic value）. The concentration of serum creatinine and cystatin C before and after operation were observed and recorded. The incidence of postoperative acute kidney injury was calculated and the influence of different blood pressure management on early postoperative acute kidney injury were evaluated. The number of patient admitted to ICU after surgery，postoperative hospital stay and the death rate within 30 days after operation were recorded，and the effect of different blood pressure management on the prognosis of elderly patients was evaluated. Results Compared with the basic values，the concentrations of serum creatinine and cystatin C were increased in the early postoperative period in groups（P＜0.05）；Compared with group S，the concentrations of serum creatinine and cystatin C in group I decreased after surgery，the incidence of AKI in early post⁃operation decreased significantly （P＜0.05）. Compared with group S，the number of patient admitted to ICU after surgery and hospital stays were significantly reduced in group I（P＜0.05）. Conclusions Maintaining MAP within 90% ~ 110% of the basic value during surgery could reduce the incidence of early acute kidney injury in elderly patients undergoing major abdominal surgery.

Key words:

blood pressure, old age, abdominal surgery, acute kidney injury