静脉-静脉体外膜肺氧合患者早期康复方案的构建

doi:10.3761/j.issn.2096-7446.2022.04.003

摘要/Abstract

摘要： 目的基于循证理念构建静脉-静脉体外膜肺氧合（venovenous extracorporeal membrane oxygenation,VV-ECMO）患者早期康复方案。方法采用文献回顾法构建VV-ECMO患者早期康复初步方案。2022年1月—2月,运用德尔菲法对15名专家进行2轮函询,形成VV-ECMO患者早期康复最终方案。结果 2轮专家函询问卷回收率均为100%,权威系数为0.840, 2轮专家函询各条目变异系数分别为0~0.353和0~0.237,肯德尔和谐系数分别为0.137（χ²=164.538,P<0.001）和0.123（χ²=147.066,P<0.001）。最终形成包括4项一级指标、16项二级指标、45项三级指标的VV-ECMO患者早期康复方案。结论 VV-ECMO患者早期康复方案具有一定的科学性与可行性,可为静脉-静脉体外膜肺氧合患者早期康复提供临床实践理论指导。

关键词: 体外膜肺氧合, 早期活动, 康复护理, 德尔菲技术, 危重病护理

Abstract: Objective An early rehabilitation program for patients with veno-venous extracorporeal membrane oxygenation was established based on evidence-based theory. Methods A preliminary program for early rehabilitation of patients with veno-venous extracorporeal membrane oxygenation was constructed by literature review. From January to February 2022,the Delphi method was used to conduct two rounds of 15 experts' consultation,and the final plan was revised based on expert opinions to form the final program. Results The response rates of the two rounds of expert letter questionnaires were both 100%. The expert authority coefficient was 0.840. The coefficients of variation of each item in the two rounds of expert consultation were 0 to 0.353 and 0 to 0.237,and the Kendall's coefficients of concordance were 0.137（χ²=164.538,P< 0.001） and 0.123（χ²=147.066,P< 0.001）. The final early rehabilitation program for patients with veno-venous extracorporeal membrane oxygenation included 4 first-level indicators,16 second-level indicators,and 45 third-level indicators. Conclusion The early rehabilitation plan for patients with veno-venous extracorporeal membrane oxygenation has certain scientificity and feasibility,and can provide theoretical guidance for clinical practice in the early rehabilitation of patients with veno-venous extracorporeal membrane oxygenation.

Key words: Extracorporeal Membrane Oxygenation, Early Mobilization, Rehabilitation Nursing, Delphi Technique, Critical Care Nursing

辛晨, 魏丽丽, 盖玉彪, 郭小靖, 张艳, 张宇辰. 静脉-静脉体外膜肺氧合患者早期康复方案的构建[J]. 中华急危重症护理杂志, 2022, 3(4): 305-311.

XIN Chen, WEI Lili, GAI Yubiao, GUO Xiaojing, ZHANG Yan, ZHANG Yuchen. Construction of early rehabilitation program for patients with veno-venous extracorporeal membrane oxygenation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022, 3(4): 305-311.

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