儿童挤压综合征的血液净化治疗

Crush syndrome in children and the blood purification treatment

近几年全球频繁发生的地震灾害使挤压综合征（CS）的发生率明显升高。CS是人体四肢、躯干遭受重物砸压伤，出现出血及肿胀，肌肉组织发生坏死，大量的毒素进入体内而产生的一系列症状，包括低血压、肾功能受损等表现，严重者将会因急性肾损伤（AKI）而致死。CS—AKI时，血中尿素氮、钾离子浓度的上升速度比一般AKI快；多种免疫细胞激活，产生大量炎症因子；血流动力学不稳定，因此，提倡及早进行血液净化治疗，迅速清除体内过多的代谢产物，减少心血管并发症的发生，以免肾功能发生不可逆改变。

In the recent years,the earthquake occured frequently in the whole world which caused the increased incidence of crush syndrome （ CS ）. The four limbs and torso will be bleeding and swelling when they are prounded and crushed from the heavy objects. The necrosis of muscular tissue causes massive production of toxin which leads to a series of symptoms including hypotension,kidney dysfunction and so on. The serious acute kidney injury （AKI） will be vital. When CS-AKI ,the ascending velocity of urea nitrogen and K ^＋ levels in the blood is quicker than those of general AKI;many kinds of immune cells are activated to engender a great deal of inflammatory mediators;the blood dynamics is often unstable. Therefore, it is advocated that the blood purification treatment should be carried early to eliminate excessive metabolic produces in vivo, to reduce the cardiovascular complication occurrence, and to avoid the irreversible change of the kidney function.