目的 探讨基于约翰霍普金斯最高水平活动量表的早期目标导向活动在ICU机械通气脱机困难患者中的应用效果。 方法 选取广州市某三级甲等医院ICU收治的脱机困难患者为研究对象，2023年7月—2024年12月收治的患者为试验组，实施以霍普金斯最高水平活动量表为目标导向的早期活动；2022年1月—2023年6月收治的患者为对照组，实施常规康复训练。比较两组患者的ICU获得性衰弱发生率、ICU住院时间、机械通气时间、撤机成功率等。结果 共96例患者完成研究，两组各48例。试验组ICU获得性衰弱发生率、撤机成功率均高于对照组，差异具有统计学意义（P<0.05），试验组ICU住院时间、机械通气时间均低于对照组，差异具有统计学意义（P<0.05）。结论 基于约翰霍普金斯最高水平活动量表的早期目标导向活动能有效降低机械通气脱机困难患者ICU获得性衰弱的发生率，缩短ICU住院时间及机械通气时间，提高撤机成功率，加快患者康复。

Objective To investigate the effects of the goal-oriented mobilization based on the Johns Hopkins Highest Level of Mobility in ICU patients with difficult weaning from mechanical ventilation. Methods Patients with weaning difficulties from ICU of a tertiary class A hospital in Guangzhou City from July 2023 to December 2024 were selected as the experimental group，and early mobilization based on the Johns Hopkins Highest Level of Mobility was implemented. Patients with weaning difficulties admitted from January 2022 to June 2023 were selected as control group，and routine rehabilitation training was carried out. The incidence of ICU acquired weakness，length of stay in ICU，duration of mechanical ventilation and success rate of weaning were compared between the two groups. Results 96 patients completed the study，including 48 in the control group and 48 in the experimental group. The incidence rate of ICU acquired weakness and weaning success rate of the experimental group were higher than those in the control group，and the differences were statistically significant（P<0.05）. The length of stay in ICU and mechanical ventilation time of the experimental group were lower and the differences were statistically significant（P<0.05）. Conclusion Goal-oriented early mobilization based on the Johns Hopkins Highest Level of Mobility can effectively reduce the incidence of ICU acquired weakness，shorten ICU stay and mechanical ventilation duration，improve weaning success rate，and accelerate patient recovery.