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。

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.