Abstract:

Objective To form the expert consensus on postoperative pulmonary rehabilitation nursing for lung transplant patients，standardize the nursing care of pulmonary rehabilitation after lung transplantation in medical institutions，and promote the early postoperative rehabilitation of lung transplant patients. Methods The clinical guideline，expert consensus，systematic review，evidence summary and original research on postoperative pulmonary rehabilitation of lung transplant patients were comprehensively searched in domestic and foreign databases. The time limit for retrieval was from the establishment of databases until February 2023. The draft of the Consensus was formed based on clinical practice experience. From April to June 2023，17 experts were invited to conduct 2 rounds of expert consultation，in order to revise and improve the content of the first draft，and then conduct expert demonstration，and finally form the final draft of the consensus. Results Totally 16 experts responded，and the expert positive coefficient was 94.12%. The effective recovery rates of the 2 rounds of expert consultation were both 100%；the expert authority coefficients were both 0.941；the judgment coefficients were both 0.963；and the familiarity degree were both 0.900. The Kendall coefficients of the 2 rounds of expert consultation were 0.133 and 0.123，respectively，which were statistically significant. The consensus includes 13 themes，involving the formation and management of a pulmonary rehabilitation team, fluid management, mechanical ventilation,sequential assisted ventilation,respiratory function exercise,airway clearance，pain management,exercise management,nutritional support，immunosuppressive management,prevention and control of pulmonary complications,psychological support,and follow-up management. Conclusion The consensus is highly scientific，and can provide references and bases for clinical nursing staff to carry out pulmonary rehabilitation for lung transplant patients.

Key words: Lung Transplant, Pulmonary Rehabilitation, Nursing Care, Expert Consensus

摘要：

目的 形成肺移植患者术后肺康复护理专家共识（以下简称“共识”），规范医疗机构肺移植术后肺康复相关护理工作，促进肺移植患者术后早期康复。方法 全面检索国内外数据库中肺移植患者术后肺康复相关的指南、专家共识、系统评价、证据总结及原始研究等，检索时限为建库至2023年2月。 结合临床实践经验，形成“共识”初稿。2023年4月—6月，邀请17名专家进行2轮专家函询，对初稿内容进行修改、完善，并进行专家论证，最终形成“共识”终稿。结果 共有16名专家应答，应答率为94.12%。2轮函询问卷的有效回收率均为100%，专家权威系数均为0.941，判断系数均为0.963，熟悉程度均为0.900。2轮函询的肯德尔和谐系数分别为0.133和0.123（P<0.01）。“共识”包括肺康复团队的组建与管理、液体管理、机械通气、序贯辅助通气、呼吸功能锻炼、气道廓清、疼痛管理、运动管理、营养支持、免疫抑制剂管理、肺部并发症防控、心理支持、随访管理等13个方面。结论 该“共识”具有较强的科学性，可为临床护理人员开展肺移植患者术后肺康复护理工作提供参考。

关键词: 肺移植, 肺康复, 护理, 专家共识