Abstract:

To summarize the nursing experience of a patient with rhabdomyolysis complicated with acute kidney injury receiving continuous renal replacement therapy combined with hemoperfusion. Nursing points：to establish a multidisciplinary care team before treatment in order to provide whole-process management；to develop personalized nutrition management to improve nutrition status；to closely monitor the circulation of blood volume，to be alert to the occurrence of extracorporeal circulation clotting and bleeding events；to conduct strict capacity management to correct electrolyte and acid-base balance disorders；to monitor the condition of deep vein thrombosis of lower extremity and prevent pulmonary embolism；to beware of first-use syndrome to implement response measures rapidly；to carry out limb function exercise to prevent muscle atrophy. After careful treatment and care，the patient was successfully discharged from the hospital after 12 d. The patient was followed up in the outpatient clinic for 3 months. Outpatient follow-up lasted for 3 months，and all indicators were in the normal range，and the patient recovered well.

Key words: Rhabdomyolysis, Acute Kidney Injury, Continuous Renal Replacement Therapy, Hemoperfusion, Nursing Care

摘要：

总结1例横纹肌溶解合并急性肾损伤患者行连续性肾脏替代治疗联合血液灌流的护理经验。护理要点：组建多学科照护团队，提供全程管理；开展个性化营养管理，改善营养状况；密切监测循环血容量，警惕体外循环凝血及出血事件发生；严格进行容量管理，预防电解质及酸碱平衡紊乱；监测下肢深静脉血栓情况，预防肺栓塞；警惕首次使用综合征，迅速实施应对措施；开展肢体功能锻炼，预防肌肉萎缩。经过精心治疗与护理，12 d后顺利出院。门诊持续随访3个月，各项指标均处于正常范围，患者恢复良好。

关键词: 横纹肌溶解, 急性肾损伤, 连续性肾脏替代治疗, 血液灌流, 护理