目的 构建静脉-动脉体外膜肺氧合（venous-arterial extracorporeal membrane oxygenation，VA-ECMO）患者下肢缺血预防方案，早期识别下肢缺血，从而减少缺血并发症时 间，改善患者生存质量。 方法 采用文献回顾法构建VA-ECMO患者下肢缺血预防方案，运用德尔菲法对20名专家进行2轮函询，形成VA-ECMO患者下肢缺血预防最终方案。 结果 2轮专家函询问卷有效问卷率均为100%，权威系数为0.83和0.87，2轮专家函询各条目变异系数分别为0.05～0.12和0.07～0.21，肯德尔和谐系数分别为0.121（χ2=89.798，P＜0.001）和0.193（χ2= 141.308，P＜0.001）。 最终形成4个维度、共26个条目的VA-ECMO相关下肢缺血预防方案。 结论 VA-ECMO患者下肢缺血预防方案具有较高的科学性与可行性，有利于减少VA-ECMO下肢缺血的发生，促进下肢缺血的早期识别，为患者生存质量提供保障。

Objective To construct a scheme for prevention of lower limb ischemia in patients with venous-arte- rial extracorporeal membrane oxygenation，which can further reduce the occurrence of lower limb ischemia and iden- tify the occurrence of lower limb ischemia in the early stage，so as to shorten the time of ischemic complications and improve the quality of life. Methods To construct literature review on the venous-arterial extracorporeal mem- brane oxygenation related lower limb ischemia prevention program，20 experts were queried twice using the Delphi method to form the final plan for the prevention of lower limb ischemia in patients with venous-arterial extracorpo- real membrane oxygenation. Results The response rates of the two rounds of expert consultation were 100%，the authority coefficients were 0.83 and 0.87，and the variation coefficients of each item of the two rounds of expert consultation were 0.05-0.12 and 0.07-0.21，respectively，Kendall’s harmonic coefficients were 0.121（χ2=89.798，P<0.001） and 0.193 （χ2=141.308，P<0.001），respectively. Finally，a 4-dimensional，26-item venous-arterial extracorporeal mem- brane oxygenation related lower limb ischemia prevention protocol was formed. Conclusion The prevention protocol for venous-arterial extracorporeal membrane oxygenation related lower limb ischemia is scientific and feasible. It can reduce the occurrence of lower limb ischemia and promote the early recognition of lower limb ischemia，to ensure the quality of life of patients.