【摘要】 文章探讨造血干细胞移植常见严重并发症的管理。重点介绍了脓毒症诊断、早期集束化管理、降钙素原和乳酸在诊断和严重评估中的价值；严重细胞因子风暴分级管理策略；重度出血ICU中综合管理策略；急性呼吸衰竭病因鉴别和呼吸支持管理；急性肾损伤接受连续性肾替代治疗指征及实施策略；心血管严重并发症移植前评估和急性发作期处理；肝窦隙阻塞综合征特异性治疗以及液体平衡等管理原则；中枢神经系统重症的病因分类、诊断和治疗原则。强调造血干细胞移植重症管理重点在于“防大于治”，早期识别重症、分层诊疗、评估转入ICU时机以及重视多学科团队会诊。最后，展望血液重症单元与层流隔离病房融合的构想。更多还原

【Abstract】 This article explores the comprehensive management of common and severe complications arising from hematopoietic stem cell transplantation(HSCT).The key points focus on the diagnostic criteria of sepsis,early implementation of bundled care protocols,and the clinical administration of biomarkers such as procalcitonin and lactate in both diagnosis and severity stratification of sepsis;Graded management strategy of s evere cytokine release syndrome;ICU management of severe bleeding;Acute respiratory failure:systematic d ifferential diagnosis of underlying causes and tailored strategies for respiratory support;Acute kidney injury:clear indications for continuous renal replacement therapy;Cardiovascular complications:Pre-HSCT risk assessment and acute phase management protocols for severe cardiovascular events;Sinusoidal obstruction syndrome:specific treatment modalities and fundamental principles of fluid balance management to prevent complications.Central nervous system disorders:classification,diagnostic pathways,and treatment guidelines.The core principles in managing critically ill HSCT patients revolve around "prevention outweighing treatment",underscored by early identification of highrisk cases,stratified diagnosis and treatment,timely admission to ICU,emphasis on multidisciplinary team collaboration for comprehensive care.Finally,we make an future outlook for a clinically significant model of integration of hematology intensive care unit with laminar flow wards.更多还原