The particularity analysis of postoperative nursing after thoracoscopic pulmonary segment resection and nursing-improvement scheme

Abstract

Objective To analyze the particularity of the nursing care after thoracoscopic pulmonary segment resection, propose the improved nursing scheme and demonstrate its effect. Methods 60 patients who underwent single-utility-port single-lobectomy or single-segmentectomy of thoracoscopic surgery from September 1, 2015 to August 31, 2016 at the Affiliated Hospital of Xiamen University were divided into 3 groups according to surgery method and nursing scheme. The nursing scheme for lobectomy and segmentectomy were defined as common nursing and special nursing, respectively. Group 1 included 18 patients who underwent lobectomy surgery and received common nursing; group 2 included 21 patients who underwent segmentectomy surgery and received common nursing; group 3 included 21 patients who underwent segmentectomy surgery and received special nursing. The special nursing measures refer to enhanced postoperative respiratory care, prolonged chest-tube removal time, postoperative discomfort index assessment and adequate pain relief. The differences in postoperative chest drainage volume, complication rate, discomfort index, and days of hospital stay were compared among the three groups. Results There was no significant difference in the average age, gender composition, operation time, intraoperative blood loss, postoperative chest drainage volume among the three groups (P>0.05). The discomfort index on the 1st and 5th day after operation in the group 2 was significantly higher than that in the other groups. However there was no significant difference of the discomfort index on the 3rd day among the 3 groups. But postoperative hospital stay time of group 2 was longer than that of the other groups. Conclusions Due to different surgical operations, there are some special features in the postoperative nursing between segmentectomy and lobectomy. The improved nursing scheme can reduce postoperative complications, reduce postoperative discomfort and shorten hospital stay. Key words: Thoracoscopic pulmonary segment resection; Postoperative care; Pain assessment; Discomfort index; Hospital stay time