ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (3): 322-324.doi: 10.3761/j.issn.2096-7446.2026.03.012

• 重症护理研究 • 上一篇    下一篇

老年肺移植并发横纹肌溶解患者行连续性肾脏替代治疗的护理

徐雅玲(), 袁静*(), 张玉姣(), 王微娜, 应金萍   

  1. 浙江大学医学院附属第一医院护理部 杭州市 310013
  • 收稿日期:2025-05-07 出版日期:2026-03-10 发布日期:2026-03-02
  • 通讯作者: 袁静 E-mail:1190037@zju.edu.cn;1183033@zju.edu.cn
  • 作者简介:徐雅玲：女，本科，主管护师，E-mail：1190037@zju.edu.cn

Nursing care for an elderly patient undergoing lung transplantation complicated with rhabdomyolysis and receiving continuous renal replacement therapy

XU Yaling(), YUAN Jing*(), ZHANG Yujiao(), WANG Weina, YING Jinping   

  1. Nursing Department， the First Affiliated Hospital， Zhejiang University School of Medicine
  • Received:2025-05-07 Online:2026-03-10 Published:2026-03-02
  • Contact: YUAN Jing E-mail:1190037@zju.edu.cn;1183033@zju.edu.cn

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摘要：

总结1例肺移植患者合并横纹肌溶解行连续性肾脏替代治疗的护理体会。针对老年患者多器官功能储备差、凝血功能异常风险高、免疫抑制状态下感染风险大的问题，采取以下护理措施：早期启动连续静脉—静脉血液透析滤过治疗，采用高通量滤器强化肌红蛋白清除；实施阶梯式抗凝方案，优化抗凝策略；强化导管维护，预防感染。经过30 d个体化治疗与护理，患者肌酸激酶由12 450 U/L降至287 U/L，下肢肌力由2级恢复至4级，未发生出血、感染等并发症，顺利转为间歇性肾脏替代治疗，最终病情稳定出院。

关键词: 肺移植, 横纹肌溶解, 连续性肾脏替代疗法, 危重病护理

Abstract:

This paper summarized the nursing experience of a lung transplant patient with rhabdomyolysis who underwent continuous renal replacement therapy. For elderly patient with poor multi-organ functional reserve，high risk of abnormal coagulation function，and high risk of infection under immunosuppression，the following nursing measures were taken：early initiation of continuous veno-venous hemodiafiltration mode treatment，using high-flux filters to enhance myoglobin clearance；implementing a stepwise anticoagulation plan，optimizing the anticoagulation strategy；strengthening catheter maintenance to prevent infection. After 30 days of individualized treatment and nursing，the patient’s creatine kinase decreased from 12，450 U/L to 287 U/L，the lower limb muscle strength recovered from grade 2 to grade 4，no bleeding or infection complications occurred，and the patient smoothly transitioned to intermittent renal replacement therapy，ultimately achieving stable discharge.

Key words: Lung Transplantation, Rhabdomyolysis, Continuous Renal Replacement Therapy, Critical Care Nursing