3.1 General information of the patients
The sequential acupoint stimulation group, comprised of 148 male patients and 52 female patients, the age of these patients ranged within 18–57 years old, with an average age of 24.35 years old; conventional nursing group, comprised of 152 male patients and 46 female patients, the age of these patients ranged within 16–61 years old, with an average age of 25.23 years old. The gender composition and average age did not differ significantly between the 2 groups (P > .05).
3.2 After VATS was performed to treat SP, the effect of the sequential acupoint stimulation nursing and routine nursing on the pulmonary function of patients were observed and compared.
On the first, third, fifth and 30th day after the day when VATS operation was performed and different nursing methods were used to assist patients in sputum excretion, the MVV in patients was measured using a MSA99 pulmonary function detector. In addition, the SpO2 in patients was determined using an oximeter. The patients were instructed to return to the hospital for reexamination of pulmonary function on the 30th day after the operation (Table 1). The results revealed that on the fifth day after VATS treatment for SP, the difference in levels of MVV and SPO2 between the sequential acupoint stimulation group and routine nursing group were statistically significant (P < .05).
3.3 After VATS was performed to treat SP, the clinical indexes of patients in the sequential acupoint stimulation group and routine nursing group were observed.
After VATS was performed to treat SP, different nursing methods were used to assist patients in the sputum excretion and guide patients in training for respiratory function. Differences in chest tube drainage time and the postoperative length of hospital stay between the routine nursing group and sequential acupoint stimulation group were statistically significant (P < .05, Table 2).
3.4 After VATS was performed to treat SP, the PCT value of patients in the sequential acupoint stimulation group and routine nursing group were compared.
On the first, third, fifth and 30th day after the VATS operation, 2 mL of peripheral venous blood was withdrawn from each patient, and the level of PCT was determined using enzyme-linked immunosorbent assay (ELISA, Table 3). The results revealed that after VATS treatment for SP, the reduction in PCT level in the sequential acupoint stimulation group was more significant. On the third day and the fifth day post VATS operation, the difference in PCT level was statistically significant, when compared with the routine nursing group (P < .001).
SP is one of the most common diseases in clinical practice, and is also the most common emergency in thoracic surgery. Surgical treatment remains one of the main treatment methods. In the present study, in addition to strictly mastering basic nursing skills and paying attention to individualized nursing and treatment, the investigators took the unique theories and concepts of traditional Chinese medicine into account, and adopted the self-created nursing method for pulmonary function recovery during the perioperative period. That is, the sequential acupoint stimulation method was used to help the patient recover their pulmonary function after the operation. The results of the present study revealed that the following: In the present study, on the first and third day after operation, damage to pulmonary function was the most serious. However, since different nursing methods were used for sputum excretion after the operation, on the fifth day after the operation, in terms of the MVV and SpO2 levels in patients, the differences between the sequential acupoint stimulation group and routine nursing group were statistically significant. The result suggests that the sequential acupoint stimulation method is superior to the routine nursing method. The pulmonary function of patients was re-examined on the 30th day after the operation. At this time point, the differences in the levels of MVV and SPO2 between the 2 groups were not statistically significant. The results of the present study were consistent with the results reported in previous literatures. Due to similar surgical procedures, that is, VATS, was used to treat SP, the difference in postoperative drainage volume between the sequential acupoint stimulation group and routine nursing group was not statistically significant. However, patients in the sequential acupoint stimulation group adopted the nursing method of tapping the corresponding acupuncture points to discharge sputum, in order to promote the excretion of inflammation. Therefore, the placement time of the drainage tube was shortened. Hence, the difference in postoperative drainage time between the sequential acupoint stimulation group and routine nursing group was statistically significant. In addition, since the thoracic drainage tube was removed from these patients, they could be discharged from the hospital after recruitment maneuver, as suggested by the chest x-ray examination and the discontinuation of antibiotics. Thus, the postoperative length of hospital stay of patients was greatly shortened. Hence, the difference in discharge time between the sequential acupoint stimulation group and the routine nursing group was statistically significant. During the surgery, trauma to the patient was inevitable, and the inflammatory response of the body was also inevitable. PCT is an acute inflammatory reaction protein and marker, which has a dual role in the occurrence and development of inflammatory reaction and in stimulating the production of inflammatory mediators.[17,18] When the body is infected, it can be vigorously produced, and has an early diagnostic role for many infectious diseases. Due to its high specificity and sensitivity, it is mainly used for the early evaluation of postoperative inflammatory complications. In the present study, on the first day after VATS treatment for SP, the PCT level was approximately 10 times of that of the normal level. This may have been induced by the surgical trauma or inflammatory reaction of the wound sites. However, since different modes of nursing were applied after the operation, sequential acupoint stimulation nursing could promote the excretion of inflammation. On the third day and fifth day post-operation, the reduction in PCT level in patients in the sequential acupoint stimulation group was more significant. The difference in PCT level was statistically significant, when compared with the routine nursing group.
We did not do follow-ups after 30 days of the operation, therefore we did not know whether the sequential acupoint stimulation could prevent the recurrence of spontaneous pneumothorax. In our future studies, we will follow-up these patients, and more results may be obtained. The treatment of meridian acupuncture points is a method that has been handed down from thousands of traditional Chinese medicine, The meridians and acupoints were not actually dissected. But the independent approach to treatment outside Western medicine has been proven to be effective for thousands of years, Lack of basic research data that Western medicine can understand, It is a traditional of Chinese Medicine clinical experience. Size of power used is Patients can tolerate it, there is no uniform strength standard. This is the limitation and shortcoming of the study.
In conclusion, results from the current study revealed that in spontaneous pneumothorax patients who underwent VATS, sequential acupoint stimulation nursing was significantly more effective than routine postoperative nursing in promoting postoperative recovery of lung function, alleviating inflammatory response and shortening hospitalization days. Therefore, sequential acupoint stimulation is a potential effective method for patients with pneumothorax and undergo VATS.
Thanks for the support from the project of Binhai New Area of Tianjin (2014BWKY009).
Conceptualization: Tie-Quan Sui, Li-Ping Sun.
Data curation: Fa-Yue Zhang, Ai-Ling Jiang, Xiu-Qiang Zhang, Zhi-Wei Zhang, Yang Yang.
Formal analysis: Tie-Quan Sui.
Investigation: Tie-Quan Sui, Fa-Yue Zhang, Ai-Ling Jiang, Xiu-Qiang Zhang, Zhi-Wei Zhang, Yang Yang.
Methodology: Tie-Quan Sui, Li-Ping Sun.
Project administration: Li-Ping Sun.
Resources: Fa-Yue Zhang, Ai-Ling Jiang, Xiu-Qiang Zhang, Yang Yang.
Software: Ai-Ling Jiang, Zhi-Wei Zhang, Yang Yang.
Supervision: Li-Ping Sun.
Writing – original draft: Tie-Quan Sui.
Writing – review & editing: Fa-Yue Zhang, Ai-Ling Jiang, Xiu-Qiang Zhang, Zhi-Wei Zhang, Yang Yang, Li-Ping Sun.
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Keywords:Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
MVV; PCT; sequential acupoint stimulation nursing; spontaneous pneumothorax; video-assisted thoracic surgery