Chest diseases can have an impact on patients' lung function, while smoking can affect the airway mucosa, leading to poor ciliary movement, increased airway secretions, and retention of secretions, which can easily lead to complications such as atelectasis and respiratory failure. During the surgical process of open chest surgery, patients may experience damage to the integrity of the chest, intercostal muscles, negative pressure in the chest cavity, or compression and traction of lung tissue during surgery, as well as increased tracheal secretions caused by postoperative excitation of the vagus nerve. Postoperative pain and weakness can lead to ineffective coughing and expectoration, resulting in the inability of secretions to be discharged smoothly. All of the above reasons can increase the incidence of respiratory complications in patients and affect their recovery time. Respiratory training for patients with lung diseases and open chest surgery can accelerate recovery and has significant application effects. Effective and reasonable respiratory training can promote rapid recovery of lung function, significantly reduce the occurrence of pulmonary complications, shorten treatment time, alleviate patient pain, and improve patient quality of life.
1. The impact of respiratory training on patients undergoing open chest surgery
① Respiratory training can improve lung function in patients undergoing open chest surgery. Improving lung function is the main purpose of implementing respiratory training. Open chest surgery can affect negative pressure in the chest cavity and affect the patient's lung function, while respiratory training exercises the patient's lung function through various measures, effectively improving lung function. ② Respiratory training can improve prognosis. The impact of open chest surgery on patients' lung function is unavoidable and completely preventable, which can affect the prognosis of patients. Respiratory training improves the respiratory function of patients by training their respiratory function, which is beneficial for enhancing treatment outcomes. ③ Respiratory training can accelerate patients' postoperative recovery. Delayed recovery of lung function can prolong treatment time, such as extubation time and hospitalization time, which is detrimental to postoperative recovery and increases patient pain. Respiratory training can improve patients' lung function, accelerate postoperative recovery, and shorten treatment time. ④ Respiratory training can reduce the incidence of complications in open chest patients. In clinical practice, it has been found that respiratory training significantly reduces the incidence of pleural effusion and atelectasis in patients undergoing open chest surgery, indicating that respiratory training plays a certain role in preventing complications.
2. Respiratory training content
Patients undergoing open chest surgery can use methods such as explosive coughing, breathing exercises, and balloon blowing for respiratory training. The details are as follows: ① Explosive coughing: The training process includes deep breathing, breath holding, closing the glottis, and coughing. Before training, the nurse should explain the training methods to the patient, emphasize the training focus, first explain the simulation exercise to the patient, then guide the patient to practice, and supervise the active implementation. Explosive cough can help patients expel phlegm deep in the respiratory tract. Exercise 3-5 times a day for 5-10 minutes each time. ② Breathing exercises: This breathing training method is very common in clinical practice, mainly including squatting, bending, chest expansion and other movements, as well as moderate aerobic exercises such as climbing stairs and walking slowly. Train 3-5 times a day for 3-4 minutes each time. ③ Balloon blowing method: This is an artificial resistance training method where as the volume of the balloon increases, the patient's expiratory resistance increases. The patient's lung function is exercised through repeated exhalation and inhalation exercises, thereby promoting the recovery of lung function. Train 3-5 times a day for 3-5 minutes each time. Blowing balloons has strong fun and is very popular among children with illnesses. ④ Abdominal breathing: This is also a common training method in clinical practice, which has the effect of enhancing diaphragm movement ability, gas exchange ability, and improving patients' lung function. Abdominal breathing is different from normal breathing methods. During exhalation, the upper abdomen should remain raised, while during inhalation, the upper abdomen should be depressed and the chest should not change. ⑤ Pursed lip breathing: This method involves changing the shape of the lips to slowly blow gas out of them. The lip tightening training uses candles as props, placing a candle in front of the patient. When the candle is tilted and will not go out, it indicates that the training effect is very good. ⑥ Respiratory function trainer: The respiratory function trainer is a product of the continuous development of modern science and has a certain reputation in clinical practice. The respiratory function trainer can train patients to take deep, even and slow breaths, and control their inspiratory volume and speed based on volume settings and scale prompts. The deep slow inhalation mode can fully dilate the chest, increase the negative pressure in the pleural cavity, promote lung expansion, improve the effective ventilation and tidal volume of the alveoli, and prevent complications such as lung infection and atelectasis. Clinical practice has found that respiratory function training devices can reduce the respiratory rate of patients undergoing open chest surgery, increase gas diffusion and exchange, and prevent postoperative hypoxemia. The respiratory training equipment currently used in clinical practice has both inhalation and exhalation training functions, which is more conducive to patient use.
Patients with weak physical constitution cannot experience explosive coughing. They can first take a deep breath and then cough continuously to promote the oscillation of airway cilia and drive sputum to be discharged outward, which is beneficial for sputum to be expelled, maintaining airway patency, promoting lung expansion, and also facilitating the recovery of lung function.
Respiratory training is not only carried out after surgery, but also applicable to rehabilitation training for respiratory diseases and patients before surgery. Especially for preoperative patients, actively engaging in respiratory training is beneficial for achieving better lung function before surgery. At the same time, mastering the methods of respiratory training is beneficial for effective postoperative training and promoting rapid recovery of postoperative lung function.