Objective To summarize the perioperative nursing of patients with post-thoracotomy atelectasis treated with bronchoalveolar lavage combined with pulmonary insufflation.Methods Before operation,the nursing measures included the full preoperative preparation,full anesthesia and mental care.During the operation,the nursing focused on intensified monitoring,close cooperation with doctors in manipulation of bronchoalveolar lavage and pulmonary insufflation.After operation,the postoperative nursing was performed.Results The lung recruitments were successful in all the 12 patients.Compared to pre-operation,the arterial oxygen saturation(SaO2)and arterial oxygen partial pressure(PaO2)6 hours after treatment were significantly improved(P<0.05) while the CO2 partial pressure(PaCO2)was significantly decreased(P<0.05).There were no severe complications and no recurrence of pulmonary atelectasis.All the patients were successfully discharged.Conclusions The bronchoalveolar lavage combined with pulmonary insufflation is effective in treating post-thoracotomy atelectasis.To ensure the smooth treatment,perioperative nursing is also contributive.

Objective To investigate the effects of three external nasogastric tube fixations on unplanned nasogastric tube removal after radical esophagectomy for esophageal cancer.Methods Two hundred and thirty four esophageal cancer patients who underwent radical esophagectomy with nasogastric intubation were assigned into conventional group I(n=74),conventional group II (n=79)and experiment group(n=81)using random number table.For external fixation of the nasogastric tube,the traditional group I used“3M”silk tape,the traditional group II used a white flat strap with two knots and the experiment group used anI-shaped nasal fixation tape combined with a flapping cheek fixation tape.The three groups were compared in terms of displacement of the indwelling nasogastric tube and slippage of the tube.Results The displacement rate of nasogastric tube and the rate of slippage in the experiment group were both significantly lower than those in both conventional groups I and II(all P<0.05).Conclusion TheI-shaped nasal fixation tape combined with a flapping cheek fixation tape in fixing the nasogastric tube can effectively reduce the incidence of unplanned removal of nasogastric tube and meanwhile the patients may feel comfort and satisfactory.

Objective To evaluate the effects of active cycle of breathing techniques (ACBT) on respiratory complications of postoperative lung cancer patients. Methods One hundred non-small-cell lung cancer patients who underwent pulmonary lobectomy or segmentectomy in thoracic surgery department from April 2012 to January 2014 were assigned into the control group , while the experiment group were paired patients from February 2014 to December 2014. We applied ACBT to the experiment group for 5 days after surgical resection and afterward compared the two groups in view of incidence of respiratory complications . Result The incidences of pulmonary infection, atelectasis and hypoxemia in the experiment group were all significantly lower than those in control group (P<0.05). Conclusion ACBT strengthens endurance and force of patients′respiratory muscle group, and therefore reduces postoperative pulmonary complications.

Objective To explore the effects of enhancing confidence of active cycle of breathing technique training on pulmonary rehabilitation in elder lung cancer patients with lung resection.Methods The control group (n=35) received routine breathing exercise from September to December 2016;the intervention group (n=35) received the confidence-enhancing active cycle of breathing technique in addition to routine perioperative care from January to April 2017.We compared the 24-hours wet sputum weight,postoperative pulmonary complications,the peak expiratory flow(PEF),6-minute walk test(6MWT),and exercise self-efficacy from baseline until hospital discharge.Results The sputum weight of postoperative on day 2 and day 3 in the intervention group were significantly higher than those in the control group(P＜0.05).The PEF,6MWT and exercise self-efficacy were also improved and the differences between two groups were statistically significant(P＜0.05).However,there was no significant difference in postoperative pulmonary complications between two groups (P＞0.05).Conclusion Confidence-enhancing active cycle of breathing technique is a simple,effective and easy short-term pulmonary rehabilitation method.

Objective:To explore the effect of motivational interview combined with feedback teaching on active cycle of breathing technique(ACBT) training in lung cancer patients.Methods:A total of 632 patients with lung cancer undergoing radical resection from September 2017 to March 2019 in Sun Yat-sen University Cancer Center were selected and divided into the experimental group and the control group with 316 cases in each group by operation time. The experimental group received motivational interview combined with feedback teaching education, while the control group received routine education. The patients were followed up for 2 months. The compliance and accuracy of ACBT training, self-care ability, sputum discharge and incidence of pulmonary complications were compared between the two groups.Results:The sputum volume in the control group was (6.25±2.44), (9.28±2.63), (10.33±3.15) g in the control group and (8.74±4.17),(13.87±3.19),(14.18±4.16) g in the experimental group at 1, 2, 3 days after operation, and the differences between the two groups were statistically significant ( t values were -1.149, -2.316, -4.124, P<0.01 or 0.05). There were 56 cases(17.72%) of pulmonary complications in the control group and 33 cases (10.44%) in the experimental group. The difference in the incidence of pulmonary complications between the two groups was statistically significant ( χ2 value was 4.743, P<0.01).Two months after operation, the compliance and accuracy of ACBT training in the experimental group were better than those in the control group ( χ2 values were - 4.57, - 2.15, P<0.01).The improvement in the four dimensions after intervention in the experimental group were better than those in the control group, and the differences were statistically significant ( t values were 8.314-19.719, P<0.01). Conclusions:The motivational interview combined with feedback teaching is an effective method of health education, which is conducive to improving lung cancer patients' compliance and accuracy of postoperative ACBT training, improving patients' self-care ability, promoting the discharge of patients' sputum and reducing the incidence of pulmonary complications to promote the recovery of lung function.