中国当代医药2025，Vol.32Issue(23)：21-26,6.DOI:10.3969/j.issn.1674-4721.2025.23.04
基于4R危机理论ICU机械通气患者获得性衰弱预防管理方案的构建
Construction of a preventive management programme for acquired debili-ty in mechanically ventilated ICU patients based on the 4R crisis theory
摘要
Abstract
Objective To create a preventive management programme of acquired weakness in mechanically ventilated pa-tients in intensive care unit(ICU)according to the 4R crisis management theory,and to provide a reference basis for the early identification and prevention of acquired weakness in ICU.Methods This study was guided by the 4R crisis theory and combined with the use of literature review and group discussion to develop a preliminary management plan for the prevention of acquired weakness in mechanically ventilated patients in the ICU.Subsequently,16 experts were carefully selected from 6 tertiary-level a hospitals to carry out 2 rounds of delphi expert correspondence,and the programme was revised and improved according to the experts' opinions,and ultimately a set of scientific and systematic preventive and management programme for ICU mechanically ventilated patients with acquired debility was successfully constructed.Re-sults The result is a prevention and management programme that includes debilitation assessment and diagnosis,debilitation assessment tools,debilitation awareness training,and debilitation interventions,which contains 8 first-level items,27 sec-ond-level items,and 18 third-level items.The recovery rate of both rounds of expert correspondence was 100％,the coefficient of authority(Cr)of the experts in the first round was 0.86,the Cr in the second round was 0.88,and the Kendall's coordination coefficients of the two rounds of expert correspondence were 0.65 and 0.68(P＜0.01).Conclusion This study forms a scientific and reliable basis for the construction of the 4R crisis theory ICU mechanical ventilation patient acquired weakness prevention and management programme,which can provide standardised guidance for clinical practice.关键词
4R危机理论/ICU获得性衰弱/肌无力/机械通气Key words
4R crisis theory/ICU-acquired weakness/Myasthenia/Mechanical ventilation分类
医药卫生引用本文复制引用
王井,闻庆敏,王霞,朱伟伟..基于4R危机理论ICU机械通气患者获得性衰弱预防管理方案的构建[J].中国当代医药,2025,32(23):21-26,6.基金项目
上海市静安区学科建设项目(2024BR03). （2024BR03）
