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急性肾损伤的连续性肾脏替代治疗:一例病例报告。

Continuous renal replacement therapy for acute kidney injury: a case report.

作者信息

Wang Jianmin, Bao Yiyao, Guan Lijun, Tan Linhua

机构信息

Department of Surgical ICU, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.

出版信息

Transl Pediatr. 2025 Mar 31;14(3):494-499. doi: 10.21037/tp-2024-500. Epub 2025 Mar 26.

Abstract

BACKGROUND

Acute kidney injury is a severe complication of pediatric trauma with complex and diverse mechanisms and is associated with multiple organ dysfunction. For severely injured children, renal function should be closely monitored, and continuous renal replacement therapy should be promptly initiated if there is a risk of developing severe acute kidney injury. This case report describes the treatment process of a child with acute kidney injury due to trauma, highlighting the need to improve the rapid identification of traumatic acute kidney injury risk and actively implement resuscitation strategies to protect renal function in trauma patients.

CASE DESCRIPTION

A 3-year-old boy presented with acute kidney injury following a car accident. Multi-organ dysfunction developed, and laparotomy and liver laceration repair were performed. Continuous renal replacement therapy for 7 days, plasma exchange, antimicrobial therapy, and multi-organ support were provided. A 1-year follow-up showed no organ dysfunction.

CONCLUSIONS

This case report describes the treatment process of a child with acute kidney injury due to trauma, highlighting the need to improve the rapid identification of traumatic acute kidney injury risk and actively implement resuscitation strategies to protect renal function in patients with trauma. Prompt continuous renal replacement therapy should be considered when necessary to prevent adverse outcomes.

摘要

背景

急性肾损伤是小儿创伤的严重并发症,机制复杂多样,且与多器官功能障碍相关。对于重伤儿童,应密切监测肾功能,若有发生严重急性肾损伤的风险,应及时启动连续性肾脏替代治疗。本病例报告描述了一名因创伤导致急性肾损伤患儿的治疗过程,强调了提高对创伤性急性肾损伤风险快速识别的必要性,并积极实施复苏策略以保护创伤患者的肾功能。

病例描述

一名3岁男孩在车祸后出现急性肾损伤。发生了多器官功能障碍,进行了剖腹手术和肝裂伤修复。给予了7天的连续性肾脏替代治疗、血浆置换、抗菌治疗和多器官支持。1年随访显示无器官功能障碍。

结论

本病例报告描述了一名因创伤导致急性肾损伤患儿的治疗过程,强调了提高对创伤性急性肾损伤风险快速识别的必要性,并积极实施复苏策略以保护创伤患者的肾功能。必要时应考虑及时进行连续性肾脏替代治疗以预防不良后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78cf/11982988/d73f27318960/tp-14-03-494-f1.jpg

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