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Objective Compare the effect of thoracic and abdominal mediastinal tube placement on pain and comfort in patients with minimally invasive esophageal cancer and nursing care. Methods 108 patients with squamous cell carcinoma of the thoracic esophagus were selected from December 2016 to May 2017. The patients were divided into chest group and abdominal group according to the random number comparison table, each with 54 cases. All patients underwent minimally invasive radical resection of esophageal carcinoma. The mediastinum drainage tube was placed at different locations of the chest and abdomen after operation. The duration of intubation, total drainage volume, number of dressing change before and after extubation, degree of pain and comfort after surgery were recorded, drainage tube failure and the incidence of related complication were compared between the two groups. Results There was no significant difference in duration of intubation, total drainage volume, drainage tube failure and the incidence of related complication between Patients with mediastinal tubes placed through the chest and abdomen(P>0.05). The times of dressing change before and after extubation in the abdominal group were (2.8 ± 1.0), (1.9 ± 0.6) times, those in the chest group were (4.5 ± 1.2), (3.6 ± 1.1) times, there were significant difference between the two groups (t=7.841, 9.377, P<0.01). The NRS and VAS score at 1-4 days and extubation in the abdominal group were significantly lower than those in the chest group, the abdominal group were (3.2±1.0), (2.7±0.8), (2.3±0.7), (1.9±0.7), (1.5±0.6) points and (3.7±0.8), (3.4±1.4), (3.0± 0.7), (2.6±1.0), (2.6±1.0) points, the chest group were (3.7±1.3), (3.3±1.1), (2.8±0.8), (2.3±0.8), (2.3±0.7) points and (5.0±0.9), (4.3±1.4), (4.1±1.3), (3.3±1.2), (3.6±1.0) points, there were significant difference between the two groups (t=2.443-7.247, P<0.01 or 0.05). Conclusions Intraoperative abdominal minimally invasive radical mediastinal tube placed esophageal cancer, can significantly relieve pain and improve patient comfort, reduce the frequency of dressing change before and after extubation, not only quickly improve the rehabilitation of patients, but also can avoid the waste of medical resources, it is worthy of clinical promotion.
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Objective To understand caregivers concerning on the nutritional status of patients with esophageal cancer after operation and to provide reference for esophageal cancer patients with postoperative rehabilitation guidance, to help nurses providing targeted health education for esophageal cancer patients. Methods A phenomenological approach was used to conduct unstructured interviews with 8 caregivers of patients with esophageal cancer in the cancer hospital.Data Data were analyzed by Colaizzi's phenomenological procedure. Results Through reading, analysis, reflection, classification and extraction,there were 3 themes: lacking of esophageal cancer related nutrition knowledge, but the belief of active acquisition is strong and behavior compliance is poor. Caregivers are positive about dietary nutrition;Caregivers have poor compliance and professionalism on behavior of dietetic care. Conclusions Doctors and nurses need to carry out elaborate diet instruction for caregivers of patients with esophageal cancer, to meet their nutritional knowledge needs, to provide a variety of effective and authoritative counseling channels, and to supervise their care behavior and promote patients rehabilitation as soon as possible.
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Objective To explore the establishment of animal model of allogeneic bone marrow transplantation plus thymic epithelial cells transplantation,and then examine the feasibility and effects of thymic epithelial cells transplantation applied in allogeneic bone marrow transplantation.Methods One day before transplantation the recipient BALB/C mice were given total-body irradiation,then transplanted with bone marrow cells from donor C57BL/6 mice and thymic epithelial cells from E14-16 embryonic thymus of donor C57BL/6 mice.In order to explore the appropriate irradiation dose,we set up three different dose groups:7 Gy;6.5 Gy;6 Gy.The recipient mice transplanted with BMT plus TCT served as experimental group,and those transplanted with BMT only served as control group (n =8 each).Then in vivo imaging in mammals was done to observe the thymic epithelial cells transplantation.Thymus index was measured.The thymus in each group was collected for histological examination and immunohistochemical staining of K5 and K8.Flow cytometry was used to examine the T cells subsets in peripheral blood of recipient mice 4 weeks after thymus transplantation.Results The recipient mice with 6.0 Gy TBI had long-term survival but implantation was done unsuccessfully,and those with 6.5 Gy had lower survival rate but implantation was done successfully.6.5 Gy was the minimum lethal dose and could be used as the appropriate irradiation does in this study.In vivo imaging in mammals detecting system showed the experimental group obvious fluorescent signals could be detected in the experimental group,but no fluorescence was found in the control group.Four weeks after transplantation,the thymus was bigger and thymus index was higher in the experimental group than in the control group.And the chiemra thymus of the experimental group also had normal cortex and medulla histological structure.Four weeks after transplantion,the percentages of CD4+ and CD8+ T cells of the peripheral blood in experimental group were significantly higher than in control group (P＜ 0.05).Conclusion Thymic epithelial cells can be transplanted in the thymus of the recipient mice with allogeneic bone marrow transplantation and promote the reconstitution of T lymphocytes of peripheral blood in the recipient mice.