Rehabilitation exercises for patients after chest surgery 1, coughing and sputum excretion to promote respiratory function recovery: After chest surgery, patients should actively carry out respiratory rehabilitation exercises to restore respiratory function and prevent pulmonary atelectasis and respiratory system infection. However, because postoperative patients are afraid of pain and dare not cough, resulting in the accumulation of secretions in the trachea. If the patient has a long-term smoking habit before surgery, it can increase the secretions in the bronchus, which is more likely to cause pulmonary atelectasis and lung infection, so we encourage and help patients cough and sputum excretion more after surgery. Within 24 to 48 hours after surgery, every one or two hours, the patient should take the initiative to cough and do deep breathing 5 to 10 times. Within 3 days after surgery, nurses or family members should assist patients to cough and expel sputum 4 to 6 times a day. The specific practice is: when coughing and expelling sputum, it is best to adopt a semi-recumbent position, or the patient’s preferred position: ask the patient or accompanying relatives and friends to press the wound with their hands so that the lung expansion is restricted to reduce pain, and the accompanying person holds the patient with their hands, and with one hand, tapping the patient’s back with five fingers together, from bottom to top, repeatedly so that the patient can do effective coughing and expel the sputum. If the sputum is sticky and not easy to be coughed out, tell the medical staff to do nebulized inhalation first to dilute the sputum and then pat the back to help cough and help it to be expelled. 2.Postoperative diet: Postoperative diet is one of the key factors to enhance the treatment effect. Generally speaking, except for esophageal surgery, the diet gradually returns to normal on the first day after chest surgery. Patients with esophageal cancer cannot eat orally in the early postoperative period (about 7 days), so they can have intravenous nutrition or drip nutrition solution through duodenal nutrition tube or jejunostomy tube. Generally, we should start from clear flow, and food should be light, soft and easy to digest and absorb, because surgical trauma will cause dysfunction of digestive system, so don’t be in a hurry when choosing food and feeding. Start from the simplest, and if there is no adverse reaction in the gastrointestinal tract, then transition to semi-liquid and general food. No matter before or after surgery, eat more fresh vegetables and fruits, such as green, yellow and red vegetables, shiitake mushrooms, black fungus, asparagus, lemon and red dates, etc., because fruits and vegetables are rich in vitamin C, which is a cancer inhibiting substance and can block the production of cancer cells. Do not eat or eat less stimulating food, including fried food. You can often eat some garlic, which contains anti-cancer substances. Do not smoke and do not drink alcohol. 3. Closed chest drainage: i.e. chest tube, this tube is placed in the chest cavity to drain the chest fluid. Patients with upper lobe lung resection will be left with two chest tubes on the same side, the upper tube is mainly for venting and the lower tube is mainly for draining fluid. Total pneumonectomy chest tube is clamped to prevent the mediastinum from shifting to the healthy side and affecting the respiratory capacity. 4, prevention of postoperative infections and other complications: lung infection, wound infection are common complications after open-heart surgery, they not only increase the patient’s postoperative recovery pain, aggravate the economic expenses, and even threaten life in serious cases, so the prevention of postoperative infection we attach great importance to. (1) Ensure the air circulation in the ward, open the window at least twice a day for at least 30 minutes each time (2) Prevent cross-infection and reduce the number of escorts and visitors (3) Ensure the neatness of the bed unit, visiting escorts do not sit on the bed, and uniforms are replaced promptly when contaminated with blood and fluid (4) Effective coughing and sputum excretion is also an important means to prevent pulmonary infection 5. From the first day, if the vital signs (blood pressure, respiration, pulse) are stable and the chest drainage tube is fixed, the patient can be encouraged to do bed activities. Due to the closed chest drainage, infusion and cardiac monitoring, the patient will be restricted to move out of bed. During the period of bed rest, the patient should take the initiative to do the lower limb extension and flexion exercises to promote the lower limb blood circulation. After the drainage tube is removed, the patient can be assisted to get out of bed and walk indoors for 3 to 5 minutes every 4 hours in the early stage, and later the patient can get out of bed by himself to prevent the formation of deep vein thrombosis in the lower limbs. 6, post-operative functional exercise: semi-recumbent position after waking up is conducive to drainage of pleural effusion and reduction of wound pain, while the septum muscle descends, which is conducive to improving respiratory and circulatory functions. After open thoracotomy, due to the long incision, cut off more muscles, intraoperative support or broken ribs, postoperative muscle adhesions and ankylosis can easily occur, therefore, in the rehabilitation care, the recovery of the function of the shoulder joint and chest and back muscles on the operated side is also an important part. However, patients are often afraid to move the arm on the operated side due to pain, resulting in limited range of motion of the shoulder joint. During bed rest, patients should take the initiative or be assisted by accompanying family members to perform forward and backward rotational exercises of the shoulder joint and lift the operated side arm, which can be done gradually. After getting out of bed, wall climbing exercises can be performed by: stretching the arm out flat on the side of the body, standing at an arm’s length from the wall, climbing along the wall with the fingers, keeping the arm straight, while climbing up with the hand, moving the foot towards the wall, continuing to climb up higher than the head, slowly climbing down in the opposite direction after the body leans against the wall, and returning the body to the original position. 7. Minimally invasive thoracic surgery is an inevitable trend in the development of surgery, and minimally invasive thoracic surgery has been widely carried out in the world and accepted by a wide range of patients and families. Minimally invasive thoracic surgery (thoracoscopic minimally invasive surgery) is used to treat thoracic surgical diseases, including lung cancer, esophageal cancer, mediastinal tumor, pneumothorax, funnel chest, hand sweating, and so on. Only 3-4 small holes of about 2-3cm in diameter are needed in the chest wall to complete the same surgery as the usual 25-30cm conventional surgery incision, with the same surgical effect as conventional surgery. The muscles and bones of the locomotor system are not traumatized, the function of shoulder joint activities is minimally affected and recovery is fast; the postoperative pain is significantly reduced compared with the conventional incision because the large muscles are not cut off, the ribs are not cut off or propped up, and the scapula is not pulled. Thoracoscopic surgery has little damage to pulmonary function and can maintain and improve the quality of life of patients, which is important for elderly people and patients with poor pulmonary function who have difficulty in undergoing traditional thoracic surgery.