肺移植术后急性肾损伤诊疗新进展  

New progress in the diagnosis and treatment of acute kidney injury after lung transplantation

作　　者：黄睦容 隋萌 胡春兰 唐诗笑 胡春晓 Huang Murong;Sui Meng;Hu Chunlan;Tang Shixiao;Hu Chunxiao(Wuxi Medical Center,Nanjing Medical University,Wuxi People's Hospital,Department of Anesthesiology,the Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学无锡医学中心、无锡市人民医院、南京医科大学附属无锡人民医院麻醉科,江苏无锡214023

出　　处：《器官移植》2025年第2期322-328,共7页Organ Transplantation

基　　金：江苏省科技计划重点研究项目(BE2022697);无锡市太湖人才计划国际国内顶尖医学专家团队(2019-THRCTD-1)。

摘　　要：肺移植是终末期肺病唯一有效的治疗手段,急性肾损伤是肺移植术后常见的并发症,与患者慢性肾病的发生和术后病死率增加相关。急性肾损伤发生的影响因素和机制十分复杂,临床发现肺移植围手术期的多种危险因素可能导致急性肾损伤的发生,包括术前、术中以及术后等多方面因素。早期诊断肺移植术后急性肾损伤,并及时给予干预措施对于改善患者预后具有重要意义。因此,本文就急性肾损伤的定义、肺移植术后急性肾损伤的无创评估、危险因素、预后及临床管理进行综述,以期为临床肺移植术后急性肾损伤的诊疗提供参考,提高肺移植受者生存率。Lung transplantation is the only effective treatment for end-stage lung disease.Acute kidney injury is a common complication after lung transplantation,which is related to the occurrence of chronic kidney disease and increased postoperative fatality.The factors and mechanisms affecting the occurrence of acute kidney injury are very complex.Clinically,it has been found that various risk factors during the perioperative period of lung transplantation may lead to the occurrence of acute kidney injury,including preoperative,intraoperative and postoperative factors.Early diagnosis of acute kidney injury after lung transplantation and timely intervention are of great significance to improving patient prognosis.Therefore,this article reviews the definition of acute kidney injury,non-invasive assessment,risk factors,prognosis,and clinical management of acute kidney injury after lung transplantation,aiming to provide a reference for the diagnosis and treatment of acute kidney injury after lung transplantation in clinical practice and to improve the survival rate of lung transplant recipients.

关 键 词：肺移植 急性肾损伤 慢性肾病 无创 血清肌酐 体外膜肺氧合 连续性肾脏替代治疗 液体管理 

分 类 号：R617[医药卫生—外科学] R563[医药卫生—临床医学]