安徽省30个重症监护室ECMO病人肺康复实施现状及影响因素OA
Current status and influencing factors of pulmonary rehabilitation implementation for ECMO patients in 30 ICU units in Anhui province
目的:调查安徽省30个重症监护室(ICU)单元体外膜肺氧合(ECMO)病人肺康复的实施现状,并分析其影响因素.方法:于2024年12月选择安徽省29所三级医院的30个ICU单元,采用自行编制的ECMO病人肺康复实施现状调查问卷进行调查.结果:在30个ICU单元中,有24个(80.00%)在开展ECMO肺康复前进行系统评估,评估及实施人员以ICU医生、护士、呼吸治疗师为主,基础肺康复技术应用广泛,但康复治疗师参与不足且高级技术应用有限,整体实施流程标准多不全面.除基础肺康复外,ECMO支持期间实施肺康复的ICU单元有13个(43.33%);实施肺康复的ICU单元与未实施肺康复的ICU单元在过去1年ECMO的开展例数、是否配备康复治疗师、肺康复实施流程、是否有肺康复应急预案方面比较差异有统计学意义(P<0.05).ECMO期间未实施肺康复的原因包括经验不足(100.00%)、安全顾虑(88.24%)、重治疗轻康复(70.59%)、缺乏实施团队(58.82%)等.结论:安徽省三级医院 ECMO 病人肺康复已有一定基础,但在资源配置、多学科协作、流程标准化和家属参与度方面仍需进一步完善,以提高ECMO病人肺康复实施率及实施水平.
Objective:To investigate the current status of pulmonary rehabilitation implementation for patients undergoing extracorporeal membrane oxygenation(ECMO)in 30 intensive care units(ICU)in Anhui province,and to analyze its influencing factors.Methods:In December 2024,30 ICU units from 29 hospitals in Anhui Province were selected.A self-designed questionnaire on the current status of pulmonary rehabilitation implementation for ECMO patients was used for the survey.Results:Among the 30 ICU units,24(80.00%)conducted systematic assessments before initiating ECMO pulmonary rehabilitation.The assessment and implementation personnel were primarily ICU physicians,nurses,and respiratory therapists.Basic pulmonary rehabilitation techniques were widely applied;however,participation by rehabilitation therapists was insufficient,and the application of advanced techniques was limited.Overall,the standards for the implementation process were incomplete.Besides basic pulmonary rehabilitation,13 ICU units(43.33%)implemented pulmonary rehabilitation during ECMO support.There were statistically significant differences between ICU units implementing pulmonary rehabilitation and those not implementing pulmonary rehabilitation in terms of the number of ECMO cases performed in the past year,availability of rehabilitation therapists,pulmonary rehabilitation implementation protocols,and presence of emergency response plans for pulmonary rehabilitation(P<0.05).Reasons for not implementing pulmonary rehabilitation during ECMO included insufficient experience(100.00%),safety concerns(88.24%),prioritizing treatment over rehabilitation(70.59%),and lack of an implementation team(58.82%).Conclusions:Pulmonary rehabilitation for ECMO patients in tertiary hospitals in Anhui province has achieved a certain foundation.However,further improvements are needed in resource allocation,multidisciplinary collaboration,process standardization,and family involvement to enhance the implementation rate and level of pulmonary rehabilitation for ECMO patients.
赵亚男;葛书唱;杨文宇;童玲;徐杰;李亚军
蚌埠医科大学护理学院,安徽 233030蚌埠医科大学护理学院,安徽 233030蚌埠医科大学护理学院,安徽 233030蚌埠医科大学第一附属医院蚌埠医科大学第一附属医院蚌埠医科大学第一附属医院
体外膜肺氧合重症监护室肺康复影响因素康复治疗重症护理
extracorporeal membrane oxygenation(ECMO)intensive care unit(ICU)pulmonary rehabilitationinfluencing factorsrehabilitation therapycritical care
《护理研究》 2026 (9)
1439-1447,9
安徽省教育厅高校科研项目(人文社会科学类),编号:2024AH052829安徽省"江淮名医培育工程"第一届卫生健康骨干人才
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