Pulmonary resection is one of the major operations in thoracic surgery. During the anesthesia, artificial oxygenation is reduced and sometimes the lumen is damaged due to endotracheal intubation. Lung injury and alveolar destruction are caused during surgery. Most surgical patients are middle-aged and elderly. The original respiratory infections, emphysema, and long-term smoking history make them poorly elastically retracted and their respiratory activity is limited.
( 1 ) Implement abdominal breathing
Abdominal breathing is a low-energy and high-energy breathing pattern. It increases ventilation function by increasing the activity of diaphragmatic muscle and reduces the oxygen consumption of respiratory muscles. It can also reduce the increase of knife-edge pain due to chest breathing.
On the basis of preoperative training, abdominal breathing is performed on the second day after surgery. When exhaling, the abdomen should be sunken, and the abdomen should be inspiratory while the general muscles should be relaxed. Encourage coughing, use correct coughing action, inhale first, close the throat, contract the abdominal muscles, and let go of the throat. At the same time as the drainage, use a hollow fist to shoot on the back of the patient to achieve the purpose of shaking the small bronchial secretions in the peripheral area to separate from the wall of the patient, or add ultrasonic atomization to inhale, 2-3 times a day, 10-20 times each time. minute.
( 2 ) Effective cough discharge
After the patient's vital signs are stable, the semi-recumbent position is changed and the head and upper body are too high at an angle of 30-45 degrees, so that the diaphragm muscle is lowered to a normal position, which is conducive to ventilation and chest drainage, and attention should be paid to prevent the chest strap from dressing tightly and affecting breathing. Encourage patients to do deep breathing and effective coughing on their own.
( 3 ) Postoperative limb movement
After 24 hours of surgery , patients are encouraged to perform physical exercises on the bed, especially the affected limbs. Outward rotation, external rotation, and fist movements are feasible. Lower limbs can be raised, stretched, and other bed activities. Assist patients to change position, remove the chest drainage tube to encourage patients to get out of bed activities, depending on the recovery gradually increase the amount of activity, guide patients to continue to do deep breathing exercises and lung function expansion training, and promote the early recovery of lung function.
Lower limb training: Passive or active activity of the foot. From the first day after the operation, the toes can be bent 5-7 times, 2-3 times a day; gradually increase the knees, hip joints 8-10 times, 2-3 times a day.
Upper limb training: On the second day after the operation, the patient was encouraged and supported to sit up and start the upper limb function training. The patient's upper arm was 90 degrees elbow close to the chest wall . Within the tolerable range, active internal and external rotation shoulder joints and horizontal adduction were performed.
Standing training: 2-3 days after surgery, the patient may self-support or get out of bed and began to stand beside the bed, every 10 minutes, 2 times a day, in the drainage pipe installation permit, can be paced at the bedside.
Walking training: 4 days after surgery, walking the corridors of 30 meters, 50 meters by the next day, 6 days after walking 100 meters, more than 2 times a day on foot. Those who do not finish will repeat the next day and gradually increase the number of daily walks, step by step.
Furniture Knob,Wardrobe Door Knobs,Cupboard Door Knobs,Furniture Knobs And Handles
BNF HARDWARE CO., LTD , https://www.bnfhardware.cn