目的 调查覆盖全国七大区域（华北、东北、华东、华中、华南、西南、西北）的三级甲等医院ICU护士体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）护理核心能力的现状，分析其影响因素。方法 采用便利抽样法，于2023年9月—2024年10月，使用一般资料调查表、自制的ECMO护理核心能力量表对26所三级甲等医院462名ICU护士进行调查，采用中位数和四分位数描述能力得分，单因素分析与多元线性回归分析筛选影响因素。结果 ICU护士ECMO护理核心能力总分为216（190，242）分，各维度得分标准化转换后专业发展能力（75.24%）与护理管理能力（77.00%）得分率最低。从事ECMO护理年限、是否接受过系统ECMO护理培训、护理层级、独立护理ECMO患者例数、职务为护士长是核心能力的主要影响因素（β值分别为0.149、0.144、0.532、0.165、0.128，调整后R²=0.190，P<0.001）。结论 国内三级甲等医院ICU护士ECMO护理核心能力呈现多维不均衡特征，整体处于中等水平，专业发展与护理管理能力薄弱，未来可以以全球体外生命支持组织指南标准化培训与分层认证体系为指导，构建以循证培训体系为基础、临床实践为导向、能力分层管理为支撑的专科发展路径，同时优化多学科团队中护理管理职能的赋权，系统提升ECMO护理质量。

Objective To investigate the current status of core competencies in extracorporeal membrane oxygenation（ECMO） nursing among ICU nurses in tertiary grade-A hospitals across China’s seven major regions （North China，Northeast China，East China，Central China，South China，Southwest China，and Northwest China），and to analyze the influencing factors. Methods Using a convenience sampling method，462 ICU nurses from 26 tertiary hospitals were assessed from September 2023 to October 2024. Data collection instruments included a demographic questionnaire and a self-developed ECMO Nursing Core Competency Scale. Competency scores were described using median （interquartile range），both univariate analysis and multiple linear regression model were em-ployed to identify influencing factors. Results The median total score of ECMO nursing core competencies was 216（190，242）. After standardized conversion，professional development competency（75.24%） and nursing management competency（77.00%） demonstrated the lowest attainment rates. Key influencing factors included years of ECMO nursing experience（β=0.149），completion of systematic ECMO training（β=0.144），nursing ladder（β=0.532），number of independent ECMO cases managed（β=0.165），and nurse manager status（β=0.128），collectively explaining 19% of variance（adjusted R²=0.190，P<0.001）. Conclusion ECMO nursing competencies among ICU nurses in Chinese tertiary hospitals exhibit multidimensional imbalance，maintaining an intermediate overall level with notable deficiencies in professional development and management domains. In the future，guided by the standardized training and hierarchical certification system of the Global Guidelines for Extracorporeal Life Support Organizations，a specialized development path based on evidence-based training system，guided by clinical practice，and supported by hierarchical management of abilities can be constructed. At the same time，the empowerment of nursing management functions in multidisciplinary teams can be optimized，to systematically enhance the quality of ECMO nursing.