电阻抗断层成像导向的机械通气患者肺部物理治疗方案的构建  

Construction of pulmonary physiotherapy for mechanically ventilated patients guided by electrical impedance tomography

作　　者：谷红俊[1] 张燕[2] 孟萌 张晗[1] 沈波[1] 杨庆云[1] 赵瑛 温若譞 马燕兰[3] GU Hongjun;ZHANG Yan;MENG Meng;ZHANG Han;SHEN Bo;YANG Qingyun;ZHAO Ying;WEN Ruoxuan;MA Yanlan(Department of Pulmonary and Critical Care Medicine,General Hospital of People's Libration Army,Beijing 100091,China;Nursing Department,The Eighth Medical Center,General Hospital of People's Libration Army,Beijing 100091,China;Health Service Training Center,General Hospital of People's Libration Army,Beijing 100853,China)

机构地区：[1]解放军总医院呼吸与危重症医学部,北京市100091 [2]解放军总医院第八医学中心护理部,北京市100091 [3]解放军总医院卫勤训练中心,北京市100853

出　　处：《护理管理杂志》2025年第4期312-317,共6页Journal of Nursing Administration

基　　金：国家重点研发计划课题(2021YFC0122500)。

摘　　要：目的构建电阻抗断层成像导向的机械通气患者肺部物理治疗方案,规范机械通气患者的个体化肺部物理治疗,提高气道廓清效果,促进机械通气患者快速康复。方法基于循证护理方法检索国内外相关文献,进行证据总结,小组讨论制订电阻抗断层成像导向的机械通气患者肺部物理治疗方案初稿,采用德尔菲法进行两轮专家函询,根据专家意见筛选调整方案。结果两轮函询专家权威系数均为0.954,指标重要性肯德尔和谐系数分别为0.349和0.354(P<0.001),指标可行性肯德尔和谐系数分别为0.351和0.178(P<0.001)。最终构建了包括4个一级指标(筛选对象、物理治疗、安全管理、效果评价)、11个二级指标、53个三级指标的肺部物理治疗方案。结论构建的电阻抗断层成像导向的机械通气患者肺部物理治疗方案内容详实,具有科学性、实用性和创新性,为规范性实施机械通气患者个体化肺部物理治疗提供依据。Objective To construct an electrical impedance tomography(EIT)-guided pulmonary physiotherapy for mechanically ventilated patients,standardize individualized pulmonary physiotherapy for mechanically ventilated patients,improve the effect of airway clearance and promote the rapid recovery of mechanically ventilated patients.Methods Based on evidence-based nursing methods,domestic and foreign literature was retrieved and evidence was summarized.A group discussion was conducted to formulate the first draft of the EIT-guided pulmonary physiotherapy program for patients with mechanical ventilation.The Delphi method was used to conduct two rounds of expert consultation,and the plan was screened and adjusted according to expert opinions.Results The expert authority coefficient of the two rounds of correspondence consultation was 0.954,the Kendall's harmony coefficients of the importance of the indicators were 0.349 and 0.354(P<0.001),and the Kendall's harmony coefficients of the feasibility of the indicators were 0.351 and 0.178(P<0.001).Finally,a pulmonary physiotherapy program was constructed,including 4 first level items(screening object,physiotherapy,safety management,effect evaluation),11 second level items and 53 tertiary items.Conclusion The EIT-guided pulmonary physiotherapy scheme for patients with mechanical ventilation established in the study is detailed,scientific,practical and innovative,which provides a basis for standardized implementation of individualized pulmonary physiotherapy for mechanically ventilated patients.

关 键 词：电阻抗断层成像 肺 物理治疗 机械通气 护理 

分 类 号：R473.56[医药卫生—护理学]