静脉-动脉体外膜肺氧合患者下肢缺血预防方案的构建研究  

Construction of a protocol for prevention of lower limb ischemia in patients with venous-arterial extracor-poreal membrane oxygenation

作　　者：宣吉玲 戴伟英[1] 杨湘英 叶卫国[1] 林瑶 夏柳勤[1] 曾小康[1] XUAN Jiling;DAI Weiying;YANG Xiangying;YE Weiguo;LIN Yao;XIA Liuqin;ZENG Xiaokang(Department of Critical Care Medicine,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou,310006,China;不详)

机构地区：[1]杭州市第一人民医院重症医学科,310006 [2]老年医学科

出　　处：《中华急危重症护理杂志》2023年第8期683-688,共6页Chinese Journal of Emergency and Critical Care Nursing

基　　金：浙江省医药卫生科技计划项目(2023KY944)。

摘　　要：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(x²=89.798,P<0.001)和0.193(Х^(2)=141.308,P<0.001)。最终形成4个维度、共26个条目的VA-ECM0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-arterial extracorporeal membrane oxygenation,which can further reduce the occurrence of lower limb ischemia and identify 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 membrane 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 extracorporeal 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(Х^(2)=-89.798,P<0.001)and 0.193(Х^(2)=141.308,P<0.001),respectively.Finally,a 4-dimensional,26-item venous-arterial extracorporeal membrane 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.

关 键 词：体外膜肺氧合 下肢 缺血 行德尔菲技术 衍循证护理学 

分 类 号：R459.7[医药卫生—急诊医学]