成人重症患者连续性肾脏替代治疗抗凝护理操作专家共识

doi:10.3761/j.issn.2096-7446.2026.08.010

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (8): 959-965.doi: 10.3761/j.issn.2096-7446.2026.08.010

成人重症患者连续性肾脏替代治疗抗凝护理操作专家共识

广东省护理学会脓毒症护理专业委员会, 执笔：白利平¹(), 卫政登¹, 许雅君¹, 张梦弟¹, 李伟麟¹, 董琼芳¹, 成守珍²^,^*()

¹ 中山大学附属第一医院重症一科广州市 510080
² 中山大学附属第一医院护理部广州市 510080

收稿日期:2025-09-02 出版日期:2026-08-10 发布日期:2026-08-04
通讯作者: *成守珍，E-mail：szcheng05@126.com
作者简介:白利平：女，本科，副主任护师，护士长，E-mail：bailiping@mail.sysu.edu.cn
作者贡献声明
白利平：研究指导；卫政登、许雅君、张梦弟：论文撰写；李伟麟、董琼芳：文献检索；成守珍：论文修改、研究指导

Expert consensus on anticoagulation nursing operations for continuous renal replacement therapy in adult critical care patients

Sepsis Nursing Professional Committee of Guangdong Nursing Association, Writer committee：BAI Liping¹(), WEI Zhengdeng¹, XU Yajun¹, ZHANG Mengdi¹, LI Weilin¹, DONG Qiongfang¹, CHENG Shouzhen²^,^*()

¹ Intensive Care Unit-1， Department of Critical Care Medical，the First Affiliated Hospital of Sun Yat-Sen University， Guangzhou 510080， China
² Nursing Department， the First Affiliated Hospital of Sun Yat-Sen University， Guangzhou 510080， China

Received:2025-09-02 Online:2026-08-10 Published:2026-08-04
Contact: *CHENG Shouzhen，E-mail：szcheng05@126.com

1. “共识”形成过程及结果、图1、表3.pdf(850KB)

摘要/Abstract

摘要：

目的形成“成人重症患者连续性肾脏替代治疗抗凝护理操作专家共识”（以下简称“共识”），规范成人重症患者连续性肾脏替代治疗抗凝技术实施及监测，总结成人重症患者连续性肾脏替代治疗抗凝护理技术要点。方法查阅国内外连续性肾脏替代治疗抗凝技术相关文献，结合临床护理专家的工作经验，形成初版“共识”，通过2轮专家函询，进行整理和修改，形成终版“共识”。结果 “共识”包括连续性肾脏替代治疗全身抗凝剂及局部抗凝剂的作用机理、抗凝剂的配制、全身与局部抗凝的连接方式、连续性肾脏替代治疗与体外膜肺氧合的连接与抗凝护理、抗凝期间的抗凝监测及常见并发症的观察与护理。结论 “共识”具有一定的科学性和实用性，可为成人重症患者连续性肾脏替代治疗抗凝护理及操作提供临床指导。

关键词: 成人, 重症患者, 连续性肾脏替代治疗, 抗凝, 护理操作, 专家共识

Abstract:

Objective To develop the “Expert consensus on anticoagulation nursing operations for continuous renal replacement therapy in adult critical care patients”（hereinafter referred to as the consensus），to standardize the implementation and monitoring of anticoagulation techniques in continuous renal replacement therapy（CRRT） for adult critical care patients，and to summarize the key points of nursing for anticoagulation techniques in CRRT for adult critical care patients. Methods Literature related to anticoagulation techniques in CRRT was reviewed both domestically and internationally，and combined with the work experience of clinical nursing experts，a preliminary version of the consensus was formed. Through two rounds of expert consultation，the document was organized and revised to form the final version of the consensus. Results The consensus includes the mechanisms of action of systemic and local anticoagulants in CRRT，the formulation of anticoagulants，the connection between systemic and local anticoagulants，the connection between CRRT and extracorporeal membrane oxygenation（ECMO） and anticoagulation care，anticoagulation monitoring during anticoagulation，and observation and care of common complications. Conclusion The consensus has certain scientific and practical significance，and can provide clinical guidance for anticoagulation nursing and operations in CRRT for adult critical care patients.

Key words: Adult, Critical Care Patients, Continuous Renal Replacement Therapy, Anticoagulation, Nursing Operations, Expert Consensus

广东省护理学会脓毒症护理专业委员会, 执笔：白利平, 卫政登, 许雅君, 张梦弟, 李伟麟, 董琼芳, 成守珍. 成人重症患者连续性肾脏替代治疗抗凝护理操作专家共识[J]. 中华急危重症护理杂志, 2026, 7(8): 959-965.

Sepsis Nursing Professional Committee of Guangdong Nursing Association, Writer committee：BAI Liping, WEI Zhengdeng, XU Yajun, ZHANG Mengdi, LI Weilin, DONG Qiongfang, CHENG Shouzhen. Expert consensus on anticoagulation nursing operations for continuous renal replacement therapy in adult critical care patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(8): 959-965.

图/表 2

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成人重症患者连续性肾脏替代治疗抗凝护理操作专家共识

Expert consensus on anticoagulation nursing operations for continuous renal replacement therapy in adult critical care patients

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