【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。更多还原

【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.更多还原