| Background:Spontaneous pneumothorax(SP)is a common medical emergency.It refers to the rupture of the pleura of the dirty layer and the rupture of the bulla near the lung surface without trauma or human factors,causing the gas into the pleural cavity to cause the pathological state of the pleural effusion.It can be divided into primary spontaneous pneumothorax(PSP)and secondary spontaneous pneumothorax(secondary spontaneous pneumothorax,SSP).Primary spontaneous pneumothorax(PSP)is defined as a lung free chest disease.It is a pathological condition in the pleural cavity caused by rupture of the pleura without any potential disease.It occurs in a healthy person with no basic disease.The number of patients is more male,and it is related to the height,weight and other factors.Secondary spontaneous pneumothorax(SSP)is commonly seen in the elderly,and often occurs in patients with right basal lung disease,such as chronic obstructive pulmonary disease,pulmonary tuberculosis,etc.Some patients with light symptoms can be cured by conservative treatment,including rest,needle aspiration and pleostomy,which,although safe,has a recurrence rate of up to 60%,resulting in subsequent thoracotomy.About 20% of patients require surgical treatment because of delayed or repeated attacks.Traditional surgical procedures are thoracotomy in the axillary or posterolateral incision.With the emergence of video-assisted thoracoscopic(VATS)for nearly 20 years,traditional surgical methods are rarely used.Through video-assisted thoracoscopic surgery,pulmonary bulla can be ligation,segmental or lobectomy.The subaxillary small incision combined with Thoracoscopic small incision operation(VATS),using a direct visual operation combined with a conventional thoracotomy instrument and a video-assisted thoracoscope to perform a 3-8cm surgical incision under the axilla of the patient.Because of the open vision and clear image display during the operation,it can be difficult to do.Do.VATS has the advantages of less operative trauma,less bleeding during operation,quicker postoperative recovery,less damage to heart and lung function,and short switching time.In Department of thoracic surgery,the longer the anesthesia time,the operation injury,the intubation of the trachea,the influence of the narcotic drugs and the surgical trauma,the postoperative respiratory secretions are increased,the retention is easy,the expectoration is hard,the complications such as the pulmonary infection and the atelectasis are easy to occur,and the recovery of respiratory function and the pain of the patients are increased.Even life is jeopardize.In order to promote the recovery of respiratory function and improve the cure rate of the patients as soon as possible,the nursing echelons in the Department of thoracic surgery of our hospital pay attention to the individualized nursing care at the same time,and pay attention to the individualized nursing treatment.The function of receiving stimulation and stimulating certain acupoints can regulate the functions of Zang Fu organs and Qi and blood through meridians,and stimulate the disease resistance in the body.On this basis,after retrieving and consulting the traditional Chinese medicine teachers,we have summed up the points of the clinical effects in the treatment of the recovery of lung function in the Department of thoracic surgery after the operation of the acupuncture point,the heart Yu Xue,the lung acupoint,the acupuncture point,the cream of the blind acupoint,the spleen acupoint and the kidney acupoint.By the massage of these points,a set of unique postoperative nursing methods,that is,the sequence of the series,is set up.Stimulate the acupoint method to help the patients in perioperative period recover the lung function.After the application of hundreds of patients in Department of thoracic surgery,and the monitoring of calcitonin and C reaction protein,the scientific,practical and advanced characteristics of this method were verified.No mass lung tissue was removed in minimally invasive surgery for spontaneous pneumothorax.The volume of lung tissue before and after operation was not changed significantly.Procalcitonin(PCT)is a protein,first found in the liver,and in normal people,the level of calcitonin(PCT)is very low.Because of the further research,calcitonin was found in other parts of the human body.The expression of calcitonin can be divided into calcitonin,carboxyl end peptide and amino acid peptide [1] through the expression of C-cell of thyroid tissue,C-cell of lung tissue and C-cell of islet tissue.Procalcitonin(PCT)is often used to identify bacterial and viral infections,to diagnose sepsis,to monitor rejection after renal transplantation,and some autoimmune diseases.C-reactive protein(CRP)is a marker protein produced in the acute phase of systemic inflammation.Due to the continuous increase of bacterial resistance,the injury caused by inflammation is also increasing rapidly in various diseases.CRP is an important way to distinguish infection.Acute myocardial infarction,trauma,organ or tissue infection,systemic acute inflammation,lung cancer cell infiltration and other diseases can reach a normal level of 2000 times as high as [2].C reactive protein is an important tool for guiding the use of antibiotics and monitoring the course of disease.Before 80 s,the false positive rate of detection results was high because of the backward detection method.In recent years,with the improvement of measurement methods,CRP can be quickly and accurately quantified.Doctors generally use it in clinical practice,which greatly prevents the use of antibiotics for patients with virus infection.Objective:The value of sequential acupoint stimulation nursing in the treatment of spontaneous pneumothorax after operation by VATS method and the value of procalcitonin and C reactive protein in the treatment of spontaneous pneumothorax by sequential acupoint stimulation nursing method in the treatment of spontaneous pneumothorax patients after operation.Method:According to the principle of different surgeons and patients' voluntary choice,the patients were randomly divided into two groups: the routine nursing group and the sequential acupoint stimulation nursing group.The main indexes were the maximum ventilation(MVV),blood oxygen saturation(SPO2),postoperative flow rate,postoperative drainage time,postoperative hospital days,leukocyte,C reactive protein and calcitonin(PCT).Results: 1.Fifth days after the treatment of spontaneous pneumothorax by VATS,the differences in MVV and SPO2 were statistically significant(P < 0.05)compared with those in the routine nursing group.2.There was no significant difference in the flow rate of the patients in the sequential acupoint stimulation group and the routine nursing group(P>0.05),but there was a significant difference between the two patients in the drainage time of the thoracic tube and the number of days after the operation(P<0.05).3.Compared with the routine nursing group,the white blood cells in the fifth days of sequential acupoint stimulation group had statistically significant difference(P < 0.01).4.Compared with the routine nursing group,the C reactive protein in the fifth days of sequential acupoint stimulation group had statistically significant difference(P < 0.01).5.Sequential acupoint stimulation nursing group third days and 5 days of PCT results compared with the conventional nursing group,the difference was statistically significant(P < 0.01).Conclusion:In this study,398 cases of spontaneous pneumothorax were treated with VATS,and the postoperative rehabilitation nursing treatment was carried out by different methods.Through the detection of the pulmonary function and some clinical indexes of the patients,it can be concluded that the sequential acupoint stimulation nursing therapy can help the patients recover the lung function quickly after the operation.High practicality and promotion value.In this study,three kinds of inflammatory markers were used to detect the effect of postoperative recovery,in which the PCT level was more sensitive than CRP and WBC in the recovery of postoperative lung function. |
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