连续性血液净化与新生儿急性肾损伤

新生儿急性肾损伤（ acute kidney injury，AKI）是新生儿危重症之一，在新生儿重症监护病房中的发生率高达23％，病死率25％～50％。新生儿AKI是指新生儿在低血容量、窒息、休克、缺氧、溶血、低体温等各种不利因素导致肾功能受到损害，出现少尿或无尿、电解质紊乱、酸碱平衡失调及血浆中肾排出的代谢产物（尿素、肌酐等）浓度增高。目前，新生儿AKI暂无有效的防治措施。近年来，随着血液净化技术进步，连续性血液净化（ continuous blood purification，CBP）应用范围已从儿童AKI已发展到新生儿AKI。由于新生儿血液动力学不稳定及血容量小等特点，CBP在新生儿AKI中应用仍然面临诸多问题。该文就新生儿AKI的高危因素、诊断标准、新生儿CBP治疗相关问题等进行综述。

Continuous blood purification and acute kidney injury in newborns

Acute kidney injury （ AKI） in newborns is one of neonatal critical disease,the incidence of AKI is 23%and the mortality is 25%～50%in neonatal intensive care unit （NICU）.AKI in newborns is abnormal renal function due to many various unfavorable factors,such as neonatal asphyxia,low blood volume, shock,hypoxia,hemolysis,low temperature,the clinical manifestations are oliguria or anuria,electrolyte disturbance,acid-base imbalance, high concentrations of metabolites in plasma and renal excretion （ urea, creatinine etc.） .At present,there are no effective prevention measures.In recent years,with the progress of blood purification technology,continuous blood purification （ CBP） has been used from AKI in children to AKI in newborns. Because of the neonatal hemodynamic instability and blood characteristics of small capacity, the application of CBP in the neonatal AKI still faces many problems.The paper summarizes high risk factors and diagnostic criteria of AKI in newborns,related problems of neonatal CBP treatment.