A Study Of Influences Of Early Ambulation Plan On Postoperative Accelerated Rehabilitation Of Patients With Lung Cancer

Objective To explore the safety and efficacy of early ambulation plan for patients with lung cancer after lobectomy under thoracoscope,and evaluate the effect of early ambulation plan on postoperative accelerated rehabilitation of patients with lung cancer after lobectomy under thoracoscope.To develop early ambulation plan for patients with lung resection under thoracoscope,and apply it to perioperative nursing of patients with lung cancer,to assess its clinical efficacy and provide scientific evidence for clinical practice.Methods This study belonged to the quasi-experimental study.According to the inclusion exclusion criteria,70 patients with lung cancer who underwent thoracoscopic lobectomy in the department of thoracic surgery of Peking University Shenzhen Hospital from November 2017 to September 2018 were selected by using a convenience sampling method and were divided into a control group and an intervention group according to the order of admission time.35 cases of patients who were admitted from November 2017 to March 2018 were divided into the control group and were given the routine perioperative nursing intervention of thoracic surgery for lung cancer.And 35cases of patients who were admitted from April 2018 to September 2018 were divided into the intervention group and increased the intervention of early ambulation plan on the basis of routine nursing.General demographic data and clinical data were obtained from the general data questionnaire and the perioperative registration form.The evaluation indicators included the postoperative indwelling time of thoracic closed drainage tube,first defecation time,first ambulation out of bed time,the pain scores at three days after surgery,the levels of pulse oxygen saturation at three days after surgery,the incidence of postoperative pulmonary complications,postoperative hospital stays and patients'satisfaction.The data was processed and analyzed by SPSS 22.0 statistical software.Statistical description,t test,c~2 test,Fisher's exact test,Mann-Whitney U test,and repeated measures analysis of variance etc were used to test the differences.All the statistics were analyzed by two-sided test,with P<0.05 was considered statistical significance.Results(1)Baseline data included gender,age,body mass index(BMI),occupation,education level,marital status,smoking status,drinking status,medical insurance status,preoperative combined disease,histopathological type,postoperative pathological staging,operation time and surgical site was no statistically significant differences between the two groups(P>0.05).(2)In the intervention group,the postoperative indwelling time of the thoracic closed drainage tube,the first defecation time and first ambulation out of bed time were earlier than those in the control group,and the difference was statistically significant(P<0.05).(3)Comparison of postoperative pain scores:There was no statistically significant difference in pain scores at the first day after operation between the two groups.(P>0.05).The pain scores at the second and third day after operation in the intervention group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).The two groups were compared by using repeated measures analysis of variance.It was showed that there was an interaction between the time and intervention factor of postoperative pain scores(P<0.05).The interactive contour map displayed that the pain scores were significantly lower than with the change of time in the intervention group than those in the control group.(4)Comparison of postoperative pulse oxygen saturation levels:There was no statistically significant difference in pulse oxygen saturation levels at the first day after operation between the two groups(P>0.05).The pulse oxygen saturation levels at the second and third day after operation in the intervention group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).The two groups were compared by using repeated measures analysis of variance.It was showed that there was an interaction between the time and intervention factor of pulse oxygen saturation levels(P<0.05).The interactive contour map displayed that the pulse oxygen saturation levels were significantly higher with the change of time in the intervention group than those in the control group.(5)There was no significant difference about the incidence of postoperative pulmonary complications between the two groups(P>0.05).(6)The postoperative hospital stays in the intervention group were shorter than those in the control group,and the difference was statistically significant(P<0.05).(7)The patients'satisfaction in the intervention group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The implementation of early ambulation plan in patients with lung cancer after lobectomy under thoracoscope is a safe and effective nursing measure,which can promote early ambulation out of bed and facilitate the recovery of postoperative gastrointestinal function.It can shorten the indwelling time of the closed thoracic drainage tube,reduce the postoperative hospital stays of patients and save medical resources.It also can reduce postoperative pain and improve patients exercise tolerance,thereby enhancing lung function and respiratory status,improving pulse oxygen saturation levels.At the same time,it can enhance communication between nurses and patients,improve patients'satisfaction,and accelerate postoperative recovery of patients.