Thoracoscopic surgery is widely used in fields such as thoracic surgery, cardiovascular surgery, hepatobiliary surgery, and urology. Compared to traditional open surgery, it has the advantages of less trauma, less bleeding, and faster recovery. Perioperative nursing refers to comprehensive and proactive interventions provided to patients before, during, and after surgery to reduce complications, accelerate recovery, and improve quality of life. For patients undergoing thoracoscopy surgery, the following aspects should be emphasized in perioperative care:
1. Preoperative care
Nursing staff should provide psychological care and health education. Understand the patient's condition and psychological state, strengthen psychological counseling, and increase their confidence in treatment. Patiently introduce the relevant knowledge of thoracoscopic surgery treatment, with a focus on the process and precautions after thoracoscopy. Assist patients in completing various preoperative examinations and provide timely treatment and care for any problematic results. Preoperative patients are required to abstain from smoking and alcohol, strengthen nutrition, ensure sufficient sleep to enhance immunity, and are advised to fast and drink for the prescribed time. The nurse prepares the necessary medical equipment for the surgery in advance, carefully counts the surgical instruments, prepares the instrument table, and double checks before the surgery to ensure a smooth operation.
2、 Intraoperative nursing
Cooperate with the surgeon to position the patient appropriately. Closely observe changes in various indicators such as hemodynamics in patients, and promptly assist doctors in wiping the thoracoscopic lens to ensure a clear surgical field of view. When suturing the incision, carefully count the surgical instruments to avoid leaving needles, gauze, etc. in the patient's body.
3、 Postoperative care
1. Respiratory management
Routine oxygen therapy should be administered to patients after surgery to ensure that blood oxygen saturation is above 95%. Postoperative thoracoscopy can easily lead to complications such as atelectasis or lung infection. Therefore, patients should be guided to turn over and tap their backs on time to promote lung expansion, keep their respiratory tract unobstructed, and if necessary, clear lung secretions and sputum to ensure their safe passage through the dangerous period. After surgery, regular nebulization inhalation therapy should be performed to maintain continuous humidification of the patient's airway. Daily auscultation of lung respiratory sounds should be performed to determine if there is any occurrence of lung infection.
2. Closely monitor vital signs
closely observe whether the patient experiences agitation, coughing, and other symptoms during the anesthesia recovery period. After fully recovering consciousness, the patient is sent to the ward, and nursing staff need to regularly monitor the patient's consciousness status thereafter. Patients are prone to developing symptoms of hypoxemia after thoracoscopy, so strict observation and care of the patient's vital signs are necessary after surgery. Early predictive observation should be done to detect whether the patient has symptoms of hypoxia, and carefully monitor vital signs such as heart rate and blood pressure.
3. Pain management
Inform patients that postoperative pain is a normal phenomenon and can be diverted by doing things that interest them. For patients with unbearable pain, painkillers can be used to relieve the pain. At the same time, pay attention to checking the condition of the postoperative wound and drainage tube, and make detailed daily nursing records of the catheter and incision.
4. Rehabilitation training
After the patient's physical signs stabilize, guide them to perform lung function exercises through correct coughing, respiratory training, and arm back muscle training, effectively promoting the increase of bronchial pressure and respiratory muscle tone in the patient. At the same time, assist patients in passive limb training such as turning over and bending the body, and perform bedside standing and getting out of bed activities after improving limb muscle strength.
5. Psychological care
Patients may experience fatigue, impatience, anxiety, depression, and other emotions after surgery. After calming the patient's mentality, nursing staff should inform them of the adverse effects of negative emotions on the smooth recovery of the disease and encourage patients to maintain an optimistic psychological state.
In summary, the above nursing management measures are the key to the perioperative period of thoracoscopic surgery patients. If sufficient and scientific nursing management can be obtained, it will help improve the quality of life of patients, promote the rehabilitation process, and ultimately improve disease recovery.