体外膜肺氧合患者氧合器全流程管理方案的构建及可行性分析

doi:10.3761/j.issn.2096-7446.2026.03.002

摘要/Abstract

摘要：

目的构建体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）患者氧合器全流程管理方案，为临床护理提供参考依据。方法采用文献分析法，构建ECMO患者氧合器全流程管理初步方案。2024年11月—12月，运用德尔菲法对15名专家进行2轮函询，形成ECMO患者氧合器全流程管理最终方案。结果 2轮专家函询问卷的有效回收率均为100%，权威系数为0.870和0.917，2轮专家函询各条目的重要性赋值变异系数为0~0.422和0~0.148，各条目可行性变异系数分别为0~0.235和0~0.133，重要性肯德尔和谐系数分别为0.178（χ²=101.102，P<0.001）和0.212（χ²=158.536，P<0.001），可行性肯德尔和谐系数分别为0.212（χ²=94.538，P<0.001）和0.268（χ²=106.214，P<0.001）。最终形成6个维度、共35个条目的ECMO患者氧合器全流程管理方案。结论 ECMO患者氧合器全流程管理方案具有较高的科学性、可靠性和可行性，可为临床医务人员全流程管理ECMO患者氧合器提供参考。

关键词: 体外膜肺氧合, 氧合器, 德尔菲技术, 护理

Abstract:

Objective To Construct a full-process management plan for oxygenators in patients undergoing ex-tracorporeal membrane oxygenation（ECMO） therapy，so as to provide a reference for clinical nursing.Methods The literature analysis method was adopted to construct a preliminary full-process management plan for oxygenators in ECMO patients. From November to December 2024，the Delphi method was used to conduct 2 rounds of correspondence consultation with 15 experts，and the final full-process management plan for oxygenators in ECMO patients was formed.Results The effective response rate of the expert consultation questionnaires in both rounds was 100%. The authority coefficients were 0.87 and 0.917 respectively. For the two rounds of expert consultation，the coefficient of variation for the importance of each item was 0-0.422 and 0-0.148，while the coefficient of variation for the feasibility of each item was 0-0.235 and 0-0.133 respectively. The Kendall’s concordance coefficient for importance was 0.178（χ²=101.102，P<0.001） and 0.212（χ²=158.536，P<0.001） in the two rounds，and the Kendall’s concordance coefficient for feasibility was 0.212（χ²=94.538，P<0.001） and 0.268（χ²=106.214，P<0.001） respectively. Eventually，a full-process management plan for oxygenators in ECMO patients，which included 6 dimensions and a total of 35 items，was formulated.Conclusion The full-process oxygenator management protocol for ECMO patients demonstrates high scientific rigor，reliability，and feasibility，serving as a valuable reference for clinical practitioners in optimizing ECMO oxygenator management.

Key words: Extracorporeal Membrane Oxygenation, Oxygenator, Delphi Method, Nursing Care

张帅, 高昕, 钱佳微, 王晓, 沈丹萍, 李文雅, 沈秀兰. 体外膜肺氧合患者氧合器全流程管理方案的构建及可行性分析[J]. 中华急危重症护理杂志, 2026, 7(3): 266-273.

ZHANG Shuai, GAO Xin, QIAN Jiawei, WANG Xiao, SHEN Danping, LI Wenya, SHEN Xiulan. Construction and feasibility analysis of a full-process management program for oxygenators in patients undergoing extracorporeal membrane oxygenation therapy[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(3): 266-273.

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