新生儿脓毒症合并急性肾损伤、弥漫性血管内凝血:1例报告并文献复习

Neonatal sepsis with acute renal injury and disseminated intravascular coagulation: a case report and literature review

新生儿脓毒症病情进展迅速,急性肾损伤及弥漫性血管内凝血是其常见的器官功能损害,需及早甄别,以免器官功能损害加重而危及生命。充分液体复苏是逆转脓毒症所致组织低灌注的关键。本文报道1例新生儿脓毒症合并急性肾损伤、弥漫性血管内凝血的病例资料,经过积极扩容、补充凝血因子及抗感染等治疗,第1小时扩容量达115 mL/kg后患儿循环状态趋于稳定,凝血指标、肾功能恢复正常,而避免连续性肾脏替代治疗。

Neonatal sepsis disease progressed rapidly.Acute kidney injury （AKI） and diffuse intravascular coagulation （DIC） were common organ dysfunction.It should be early screened to avoid aggravation of organ function damage and life- threatening. Adequate fluid resuscitation was the key to reversal of tissue hypoperfusion in sepsis. The paper reported a case of neonatal sepsis with AKI and DIC. After hospitalization, the baby were performed with several boluses of saline for rapid restoration of the circulating intravascular volume, supplement of the coagulation factor, and anti infective therapy. During the first hour of resuscitation phase, circulation state tended to be stable until the total isotonic fluid reached 115 mL/kg. Coagulation indicators and renal function were recovery. Continuous renal replacement treatment （CRRT） was avoided.