腹式呼吸联合抗阻运动方案对预防机械通气患者谵妄的效果研究

doi:10.3761/j.issn.2096-7446.2026.05.002

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (5): 524-531.doi: 10.3761/j.issn.2096-7446.2026.05.002

腹式呼吸联合抗阻运动方案对预防机械通气患者谵妄的效果研究

李常鑫¹(), 陈映雪², 罗陈娟¹, 郑旺敏¹, 林如玉³, 陈巧玲⁴^,^*()

¹ 福建医科大学附属南平第一医院重症医学科福建省南平市 353000
² 福建医科大学附属南平第一医院护理部福建省南平市 353000
³ 莆田市第一医院护理部福建省莆田市 351100
⁴ 福建医科大学省立临床医学院福州市 350000

收稿日期:2025-05-30 出版日期:2026-05-10 发布日期:2026-04-28
通讯作者: *陈巧玲，E-mail：920525859@qq.com
作者简介:李常鑫：男，硕士，主管护师，E-mail：845974705@qq.com
第一联系人：作者贡献声明
李常鑫：研究设计、资料收集、数据分析、论文撰写；陈映雪：方法指导、经费支持；罗陈娟、郑旺敏：技术指导、资料收集、质量控制与监督；林如玉：资料收集；陈巧玲：研究设计与指导、论文修改、投稿指导
基金资助:
南平市自然科学基金项目(N2023J018)

The effects of combined abdominal breathing and resistance exercise program on preventing delirium in ICU patients with mechanical ventilation

LI Changxin¹(), CHEN Yingxue², LUO Chenjuan¹, ZHENG Wangmin¹, LIN Ruyu³, CHEN Qiaoling⁴^,^*()

¹ Department of Critical Care Medicine， Nanping First Hospital Affiliated to Fujian Medical University，Nanping， Fujian Province 353000， China
² Nursing Department， Nanping First Hospital Affiliated to Fujian Medical University，Nanping， Fujian Prorince 353000， China
³ Nursing Department， Putian First Hospital，Putian， Fujian Province 351100， China
⁴ Fujian Medical University Provincial Clinical Medical College， Fuzhou 350000， China

Received:2025-05-30 Online:2026-05-10 Published:2026-04-28
Contact: *CHEN Qiaoling，E-mail：920525859@qq.com
Supported by:
Nanping Natural Science Foundation Project(N2023J018)

摘要/Abstract

摘要：

目的探讨腹式呼吸联合抗阻运动方案在ICU机械通气患者中的应用效果。方法选取2023年9月—2024年9月入住福建省南平市2所三级甲等医院综合ICU行机械通气治疗的192例患者为研究对象，采用简单随机分组方法，分为腹式呼吸联合抗阻运动组、早期渐进式活动组、常规活动组，观察3组研究对象谵妄发生率、焦虑抑郁评分、睡眠质量评分、ICU机械通气时间、ICU住院时间等临床结局指标。结果 3组谵妄发生率比较，腹式呼吸联合抗阻运动组<早期渐进式活动组<常规活动组，差异均具有统计学意义（P<0.05）；ICU住院期间焦虑抑郁评分、睡眠质量评分比较，腹式呼吸联合抗阻运动组和早期渐进式活动组低于常规活动组，差异均有统计学意义（P<0.05）；3组ICU机械通气时长、ICU住院时长比较，腹式呼吸联合抗阻运动组<早期渐进式活动组<常规活动组，差异均有统计学意义（P<0.05）。结论腹式呼吸联合抗阻运动可降低ICU机械通气患者谵妄发生率、改善危重患者焦虑抑郁情绪、提高危重患者睡眠质量、缩短机械通气时长及ICU住院时长，有利于改善危重患者临床结局。

关键词: 重症监护室, 机械通气, 谵妄, 方案, 抗阻运动

Abstract:

Objective To explore the application effects of the combined limb and abdominal breathing resistance exercise program in ICU patients with mechanical ventilation. Methods From September 2023 to September 2024，192 patients who underwent mechanical ventilation treatment in the general ICU of two tertiary grade A hospitals in Nanping City，Fujian Province，were selected as the research subjects. Using the simple random grouping method，they were divided into the combined limb and abdominal breathing resistance exercise group，the early progressive activity group，and the conventional activity group. The incidence of delirium，anxiety and depression score，sleep quality score，ICU mechanical ventilation time，and ICU hospitalization time of research subjects in the three groups were observed. Results Comparison of the incidence of delirium among the three groups of research subjects showed that the incidence in combined limb and abdominal breathing resistance exercise group was lower than the early progressive activity group and the conventional activity group（P<0.05）. Comparison of anxiety and depression scores and sleep quality scores during ICU stay showed that the combined limb and abdominal breathing resistance exercise group and the early progressive activity group were lower than the conventional activity group（P<0.05）. And the lengths of mechanical ventilation and ICU hospitalization in the three groups were compared，the combined limb and abdominal breathing resistance exercise group was shorter than the early progressive activity group and the conventional activity group，and the differences were statistically significant（P<0.05）. Conclusion The combination of limb and abdominal breathing resistance exercise can reduce the incidence of delirium in ICU patients with mechanical ventilation，improve the anxiety and depression of critically ill patients，improve the sleep quality of critically ill patients，shorten the duration of mechanical ventilation and ICU hospitalization，and is conducive to improving the clinical outcomes of critically ill patients.

Key words: Intensive Care Unit, Mechanical Ventilation, Delirium, Program, Resistance Exercise

李常鑫, 陈映雪, 罗陈娟, 郑旺敏, 林如玉, 陈巧玲. 腹式呼吸联合抗阻运动方案对预防机械通气患者谵妄的效果研究[J]. 中华急危重症护理杂志, 2026, 7(5): 524-531.

LI Changxin, CHEN Yingxue, LUO Chenjuan, ZHENG Wangmin, LIN Ruyu, CHEN Qiaoling. The effects of combined abdominal breathing and resistance exercise program on preventing delirium in ICU patients with mechanical ventilation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(5): 524-531.

图/表 4

参考文献 25

[1]	First MB. Diagnostic and statistical manual of mental disorders,5th edition,and clinical utility[J]. J Nerv Ment Dis, 2013, 201(9):727-729. doi: 10.1097/NMD.0b013e3182a2168a
[2]	Rahimi-Bashar F, Abolhasani G, Manouchehrian N, et al. Incidence and risk factors of delirium in the intensive care unit:a prospective cohort[J]. Biomed Res Int, 2021, 2021:6219678. doi: 10.1155/bmri.v2021.1
[3]	Marquetand J, Bode L, Fuchs S, et al. Delirium:prevalence and outcome in the very old in 27 medical departments during a one-year prospective study[J]. Palliat Support Care, 2022, 20(6):779-784. doi: 10.1017/S1478951521001814 pmid: 36942581
[4]	Devlin JW, Skrobik Y, Gélinas C, et al. Clinical practice guidelines for the prevention and management of pain,agitation/sedation,delirium,immobility,and sleep disruption in adult patients in the ICU[J]. Crit Care Med, 2018, 46(9):e825-e873. doi: 10.1097/CCM.0000000000003299
[5]	张敏, 张萌. 脑卒中患者渐进式分级康复护理的临床效果观察[J]. 护理实践与研究, 2023, 20(2):240-244.
	Zhang M, Zhang M. Observation on clinical effect of progressive graded rehabilitation nursing for patients with stroke[J]. Nurs Pract Res, 2023, 20(2):240-244.
[6]	徐嵩昊, 董德龙. 有氧与抗阻运动对老年人慢性病的影响[J]. 中国老年学杂志, 2025, 45(11):2798-2802.
	Xu SH, Dong DL. Effects of aerobic and resistance exercise on chronic diseases in the elderly[J]. Chin J Gerontol, 2025, 45(11):2798-2802.
[7]	Ormseth CH, LaHue SC, Oldham MA, et al. Predisposing and precipitating factors associated with delirium:a systematic review[J]. JAMA Netw Open, 2023, 6(1):e2249950. doi: 10.1001/jamanetworkopen.2022.49950
[8]	Lippi L, de Sire A, D’Abrosca F, et al. Efficacy of physiotherapy interventions on weaning in mechanically ventilated critically ill patients:a systematic review and meta-analysis[J]. Front Med, 2022, 9:889218. doi: 10.3389/fmed.2022.889218
[9]	王琦, 王念坚, 徐大才, 等. 早期四级锻炼对预防老年重症肺炎机械通气患者谵妄的研究[J]. 护士进修杂志, 2020, 35(3):234-237.
	Wang Q, Wang NJ, Xu DC, et al. The curative effect of early four-stage exercise on the prevention of delirium in elderly patients with severe pneumonia and mechanical ventilation[J]. J Nurses Train, 2020, 35(3):234-237.
[10]	姚彦蓉, 刘娜, 郑栋莲, 等. 个性化早期活动方案对机械通气患者肌力的影响[J]. 中华急危重症护理杂志, 2020, 1(6):500-505.
	Yao YR, Liu N, Zheng DL, et al. Influence of personalized early mobilization intervention program on muscle strength of patients with mechanical ventilation[J]. Chin J Emerg Crit Care Nurs, 2020, 1(6):500-505.
[11]	Ely EW, Gautam S, Margolin R, et al. The impact of delirium in the intensive care unit on hospital length of stay[J]. Intensive Care Med, 2001, 27(12):1892-1900. doi: 10.1007/s00134-001-1132-2
[12]	Beekman E, Verhagen A. Clinimetrics:hospital anxiety and depression scale[J]. J Physiother, 2018, 64(3):198. doi: 10.1016/j.jphys.2018.04.003
[13]	郭艳青, 王前进, 李华, 等. ICU患者睡眠障碍相关因素调查[J]. 国际精神病学杂志, 2020, 47(3):564-565,579.
	Guo YQ, Wang QJ, Li H, et al. The influence factors to sleep disorders on patients in ICU[J]. J Int Psychiatry, 2020, 47(3):564-565,579.
[14]	汤铂, 王小亭, 陈文劲, 等. 重症患者谵妄管理专家共识[J]. 中华内科杂志, 2019, 58(2):108-118.
	Tang B, Wang XT, Chen WJ, et al. Expert consensus on the management of delirium in critically ill patients[J]. Chin J Intern Med, 2019, 58(2):108-118. doi: 10.3760/cma.j.issn.0578-1426.2019.02.007 pmid: 30704197
[15]	黄定瑞. 渐进式早期康复训练对ICU机械通气病人谵妄、机械通气时间及ICU住院时间的影响[J]. 全科护理, 2021, 19(4):469-471.
	Huang DR. The effect of progressive early rehabilitation training on delirium,mechanical ventilation duration,and ICU length of stay in ICU patients undergoing mechanical ventilation[J]. Chin Gen Pract Nurs, 2021, 19(4):469-471.
[16]	Jaiswal SJ, Kang DY, Wineinger NE, et al. Objectively measured sleep fragmentation is associated with incident delirium in older hospitalized patients:analysis of data collected from an randomized controlled trial[J]. J Sleep Res, 2021, 30(3):e13205. doi: 10.1111/jsr.v30.3
[17]	张美科, 贺润莲, 刘倩, 等. 卒中后吞咽障碍Triangle分层分级管理方案在居家患者中的应用[J]. 中国护理管理, 2025, 25(6):864-870.
	Zhang MK, He RL, Liu Q, et al. Application of a triangle hierarchical management scheme in home-bound patients with post-stroke dysphagia[J]. Chin Nurs Manag, 2025, 25(6):864-870.
[18]	Buran Cirak Y, Yilmaz Yelvar GD, Durustkan Elbasi N. Effectiveness of 12-week inspiratory muscle training with manual therapy in patients with COPD:a randomized controlled study[J]. Clin Respir J, 2022, 16(4):317-328. doi: 10.1111/crj.v16.4
[19]	刘晓丽, 李晓, 姜宏英, 等. 吸气肌训练对新冠病毒感染恢复后患者呼吸功能、心理和睡眠的影响[J]. 中国康复医学杂志, 2025, 40(6):900-908.
	Liu XL, Li X, Jiang HY, et al. Effects of inspiratory muscle training on respiratory function,psychology and sleep in post-COVID-19 patients:a randomized controlled trial[J]. Chin J Rehabil Med, 2025, 40(6):900-908.
[20]	Papi S, Barmala A, Amiri Z, et al. Mediating roles of stress,anxiety,and depression in the relationship between constipation and sleep quality among the elderly:structural equation modeling(SEM)[J]. Sleep Sci, 2023, 16(1):1-6.
[21]	戴勇. 早期渐进性活动与运动康复训练在机械通气患者中的应用研究[D]. 广州: 广州中医药大学, 2021.
	Dai Y. The study of early progressive mobility and exercise rehabilitation technique in patients with mechanically ventilated patients[D]. Guangzhou: Guangzhou University of Chinese Medicine, 2021.
[22]	Schujmann DS, Teixeira Gomes T, Lunardi AC, et al. Impact of a progressive mobility program on the functional status,respiratory,and muscular systems of ICU patients:a randomized and controlled trial[J]. Crit Care Med, 2020, 48(4):491-497. doi: 10.1097/CCM.0000000000004181 pmid: 32205595
[23]	Lin TK, Chen MY, Cheng HH, et al. Effectiveness of abdominal sandbag training in enhancing diaphragm muscle function and exercise tolerance in patients with chronic respiratory failure[J]. J Formos Med Assoc, 2024, 123(10):1087-1092. doi: 10.1016/j.jfma.2024.01.021
[24]	柳月, 王琳, 袁媛, 等. 早期抗阻训练对重症患者呼吸机脱机成功的影响[J]. 中华急危重症护理杂志, 2023, 4(8):695-699.
	Liu Y, Wang L, Yuan Y, et al. Effect of early resistance training on success of ventilator off-line in patients with severe respiratory diseases[J]. Chin J Emerg Crit Care Nurs, 2023, 4(8):695-699.
[25]	da Silva Guimarães B, de Souza LC, Cordeiro HF, et al. Inspiratory muscle training with an electronic resistive loading device improves prolonged weaning outcomes in a randomized controlled trial[J]. Crit Care Med, 2021, 49(4):589-597. doi: 10.1097/CCM.0000000000004787 pmid: 33332819

腹式呼吸联合抗阻运动方案对预防机械通气患者谵妄的效果研究

The effects of combined abdominal breathing and resistance exercise program on preventing delirium in ICU patients with mechanical ventilation

RichHTML

PDF下载

可视化

摘要/Abstract

引用本文

使用本文

图/表 4

参考文献 25

相关文章 15

编辑推荐

Metrics

本文评价

[1]	刘丽, 涂萍, 黄斯瑶, 熊燕, 徐建梅. ICU经口气管插管患者口腔黏膜压力性损伤风险预测模型的系统评价[J]. 中华急危重症护理杂志, 2026, 7(5): 608-615.
[2]	张萍, 翁峰霞, 桑明, 卫建华. ICU护士应对心脏及大血管术后谵妄患者伤害行为心理体验的质性研究[J]. 中华急危重症护理杂志, 2026, 7(4): 481-487.
[3]	方业香, 韩江英, 杜小玲, 伍珊珊, 李娟, 杨雪. 知信行模式下弹性按需探视对ICU患者谵妄发生的影响[J]. 中华急危重症护理杂志, 2026, 7(2): 148-154.
[4]	黄昉芳, 胡俊, 周燕, 樊恬静, 于洪基, 高兵兵, 姜云龙. ICU机械通气患者非语言沟通需求的质性研究[J]. 中华急危重症护理杂志, 2026, 7(2): 168-174.
[5]	石敏, 翟怀香, 张星星, 徐萍, 李晓青. ICU经历机械通气的中青年患者创伤后成长水平及潜在剖面分析[J]. 中华急危重症护理杂志, 2026, 7(2): 182-189.
[6]	赵会云, 吴博, 许笑影, 唐诗. 儿童重症监护室安宁疗护质量评价指标体系的构建及适用性分析[J]. 中华急危重症护理杂志, 2026, 7(1): 36-41.
[7]	冯璐, 李艳, 敬洁, 聂新月, 胡欢, 唐彬秩. NICU新生儿操作性疼痛家庭参与式非药物管理的最佳证据总结[J]. 中华急危重症护理杂志, 2026, 7(1): 61-69.
[8]	刘海金, 吴碧瑜, 陈兰兰, 林彩霞, 陈月婷, 黄琼琼. 呼吸机湿化罐自动补液装置的设计及应用[J]. 中华急危重症护理杂志, 2026, 7(1): 123-128.
[9]	王雪琴, 吕颖, 赵庆华, 张川林, 米洁. 早期活动多学科协作模式在机械通气患者中的实施效果研究[J]. 中华急危重症护理杂志, 2025, 6(9): 1029-1035.
[10]	彭莉, 徐翠荣, 冯波, 姚媛媛, 邢星敏, 俞琳. 预防ICU连续肾脏替代治疗患者非计划下机管理方案的构建及适用性分析[J]. 中华急危重症护理杂志, 2025, 6(9): 1036-1041.
[11]	汪萍, 劳月文, 陈香萍, 董莲莲, 宫晓艳, 庄一渝. ICU护士的谵妄护理能力现状及影响因素分析[J]. 中华急危重症护理杂志, 2025, 6(9): 1112-1117.
[12]	王婷婷, 马亚君, 高雯, 张玉萍, 金静芬. 家属声音刺激预防ICU谵妄的研究进展[J]. 中华急危重症护理杂志, 2025, 6(8): 1017-1020.
[13]	幸超群, 严艳, 王洁, 高娥, 张明月, 高传英. 缺血性脑卒中患者早期非偏瘫侧渐进式抗阻运动方案的构建及效果研究[J]. 中华急危重症护理杂志, 2025, 6(7): 773-779.
[14]	中华护理学会外科护理专业委员会, 重庆医科大学附属第一医院护理部/神经外科/血管外科/重症医学科, 华中科技大学同济医学院附属同济医院护理部, （执笔：刘丽萍，张萍，朱桦，吴前胜，张川林，刘佳莉，秦静雯，刘美言）. 成人术后谵妄预防与护理专家共识[J]. 中华急危重症护理杂志, 2025, 6(7): 837-842.
[15]	安晓, 江淑敏. ICU患者亚谵妄综合征风险预测模型的系统评价[J]. 中华急危重症护理杂志, 2025, 6(7): 866-871.