中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (04): 325-329.doi: 10.3969/j.issn.1671-4091.2026.04.010

• 综述 • 上一篇    下一篇

连续性肾脏替代治疗的充分性评估

刘晨曦    赵隽永    樊心妍    唐迅子    袁 芳    刘 虹   

  1. 410011 长沙，1中南大学湘雅二医院肾内科 2肾脏疾病与血液净化湖南省重点实验室
  • 收稿日期:2025-09-25 修回日期:2026-01-12 出版日期:2026-04-12 发布日期:2026-04-12
  • 通讯作者: 刘虹 E-mail:liuhong618@csu.edu.cn
  • 基金资助:
    国家自然科学基金(82470741)；2023年湖南省卫生健康高层次人才：领军人才

Adequacy assessment of continuous renal replacement therapy

LIU Chen-xi, ZHAO Juan-yong, FAN Xin-yan, TANG Xun-zi, YUAN Fang, LIU Hong   

  1. Department of Nephrology, 2Renal Disease and Blood Purification of Hunan Province, Second Xiangya Hospital, Central South University, Changsha 410011, China
  • Received:2025-09-25 Revised:2026-01-12 Online:2026-04-12 Published:2026-04-12
  • Contact: 410011 长沙，1中南大学湘雅二医院肾内科 2肾脏疾病与血液净化湖南省重点实验室 E-mail:liuhong618@csu.edu.cn

摘要： 连续性肾脏替代治疗(continuous renal replacement therapy，CRRT)指所有持续、缓慢清除水分和溶质的体外血液净化治疗的总称，是重症患者重要的生命支持技术。随着技术发展和临床经验积累，CRRT的“充分性”评估已从传统的溶质清除剂量扩展至治疗时机、容量管理、抗凝策略、回路监测等多个维度。本文基于最新循证医学证据，系统阐述CRRT充分性评估的关键要素，包括启动时机选择、CRRT剂量与溶质清除监测、容量管理策略、抗凝治疗方案、特殊人群管理以及质量控制体系，以指导临床实践并改善患者预后。

关键词: 连续性肾脏替代治疗, 充分性, 个体化治疗

Abstract: Continuous renal replacement therapy (CRRT) is a extracorporeal blood purification method to continuously and slowly clear water and solute from blood, and has become a critical life-support technology for critically ill patients. With the advances of technology and the accumulation of clinical experience, the assessment of CRRT "adequacy" has expanded beyond traditional issue of solute clearance dosage to include multiple dimensions such as treatment timing, fluid management, anticoagulation strategies, and circuit monitoring. Based on the latest evidence-based medical research, this article reviews key elements of CRRT adequacy assessment, including selection of initial time, CRRT dosage, surveillance of solute clearance, volume management strategies, anticoagulation protocols, management of specific patients, and quality control system, in order to optimize CRRT practice and improve patient outcomes.

Key words: Continuous renal replacement therapy, Adequacy, Individualized treatment

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