连续性肾脏替代治疗处方实践与脓毒症血液净化  

Update on prescribing practices of continuous renal replacement therapy and blood purification for sepsis

作　　者：刘娇 王敏敏 刘永安 杜航向 汪涛 张李迪 陈一竹 陈彦 陈德昌 Liu Jiao;Wang Minmin;Liu Yongan;Du Hangxiang;Wang Tao;Zhang Lidi;Chen Yizhu;Chen Yan;Chen Dechang(Department of Critical Care Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201801,China;Baxter Healthcare,Shanghai 200031,China;Department of Pulmonary and Critical Care Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院北院重症医学科,201801 [2]百特医疗医学治疗发展部,上海200031 [3]上海交通大学医学院附属瑞金医院重症医学科,上海201801

出　　处：《中华重症医学电子杂志》2020年第3期260-266,共7页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

摘　　要：急性肾损伤(AKI)是临床常见疾患,当并发脓毒症时,住院治疗时间延长,更易进展到慢性肾脏疾病,医疗费用和病死率急剧增加。连续性肾脏替代治疗(CRRT)具有精确稳定控制容量,酸碱电解质平衡和稳定血流动力学的作用,是重症监护病房内肾脏替代治疗的主要模式。本综述重点回顾CRRT在重症AKI和多器官衰竭患者中的应用现状,包括模式、滤器、抗凝、处方和达成剂量、血管通路、开始和停机时机及脓毒症/AKI清除内毒素和细胞因子的研究进展。Acute renal injury(AKI)is a clinically common disease.When sepsis occurs,the hospitalization time is prolonged,and it is more likely to progress to chronic kidney disease(CKD),dramatically increasing the medical cost and mortality.Continuous renal replacement therapy(CRRT)is the main form of renal replacement therapy(RRT)in intensive care unit,which has the functions of accurate and stable volume control,correction of acid-base electrolyte balance,and stabilization of hemodynamics.This review focuses on the current situation and progress of CRRT in severe AKI,sepsis,and multiple organ failure,including mode,filter,anticoagulation,prescription and dosage,vascular access,timing of start and stop,and the clinical status of blood purification for sepsis.

关 键 词：急性肾损伤 脓毒症 吸附 连续性肾脏替代治疗 血液净化 

分 类 号：R459.7[医药卫生—急诊医学]