The sufferer of the liver cancer the nursing after the Shu

The liver cancer is one of clinical familiar tumors.Ever since December 26, 2004~November 10, 2005, my section totally did surgical operations a treatment to 8 sufferers with swollen liver cancer and realized report as follows after its Shu the nursing now.
1.Clinical data
The 8 of this sufferer all is a male, the age is 36~73 years old, on the average 54 years old.Among them left the liver cancer is 5, the right liver cancer is 3, the cancer swollen biggest 3 cm × 2 cms, minimum 1 cm × 1 cm.
2.Nursing
Understand a circumstance in Shu first, such as pathological changes mostly property and anaesthesia way, surgical operation cut off scope, bleed quantity and input liquid in the Shu of quality and quantity.
2.1 Shus observe behind and nursing after operation inside the 6 hs, take the Zhen Be even to lie and absorb oxygen, the oxygen discharge 3~4 Lsmin, absorb the oxygen 48~72 hs, carefully connect good belly cavity to lead to flow a tube, double the set tube, stomach and intestines decompression tube, reservation to lead an urine tube.The belly cavity double set tube generally useds for belly surgical operation and create noodles big, create a chamber to ooze a liquid much, can lead to flow in time, in order to prevent cause after hair the infection cause the Ge next abscess, nursing important point:(1)Keep lucid, need regulate according to the sufferer negative press(0.02~0.06 mPas), prevent°from leading to flow tube distortion and is press, blocked and shed off;(2)The observation leads to flow liquid color, property and quantity, detection unusually reports in time, such as per hour over the 200 mls, and lead to flow tube warmth or 8 hs over the 400 mls, shoulding highly doubt to have movable sex issue of blood may;(3)The double tube inside the set tube connects negative press attraction, the coat tube peeps out a skin to use a cotton mat overlay, and everyday disinfect replace;(4)Such as inside the set tube block, can flush with the 20 ml slowness in physiology brine, still not lucid at without replace under the germ condition to take care of inside the set;(5)Replace to lead to flow a bottle, dump to lead to flow a liquid once everyday etc. attention have no the germ operate;(6)Place to take care of for 3~4 days, lead to flow a liquid color such as the belly cavity thinner, 24 h quantity<20 mls, belly have no the male body advertise for to pull out;(7)The coat tube assists in childbirth 500 mls in reason brine+celebrate plain 160,000 uses of big mildeweds, replace everyday, according to leading discharge of how much carry on handstand to flush number of times, each number can carry on handstand to flush 1~2 times.
After operation 6~24 hs, awake take half to lie, tiny shut a pair of eyes, use a nose of deep breathing, instruction sufferer the arms ― elbow joint ― shoulder the joint bend to stretch to exercise and the legs toe carry the ― toe ― ankle joint ― knee joint ― Kuan the joint bend to stretch, inside turn over and outside turn over sport.Everyday 4 times, each time 10 time.The Shu enlarges movable quantity on the first stage on the 1st day(24~48 hs) behind, and increase movable item, take half to lie, the increment expands chest sport, everyday 2~3 times, 5 times of each time, the companion a cough can be turned over a body by others help, light Kou back each 2 hs is once.After the Shu on the 2nd day(48~72 hs) instruction sufferer active movable arms and legs, each 2 hs once, each time 5~10 mins, such as year old physically weak or can not descend a bed activity, should carry on lifting hip training to it, method is two leg crooked, two arms support a bed and again and again lift a hip, every day 50~100 times, gradually increment number of times, until ventilate.This method can adopt for other such as stomach, bile duct and Yi surgical operation and wriggle towards promoting bowel, ventilate soon and prevent bowel from gluing connecting to have very good curative effect.After the Shu on the 3rd day, pull out a pair of sets tubes, the Zhu sufferer is sat to a bedside, the legs bottom hangs, active movable arms and legs, head neck joint and muscle, consider feeling to support in the others under run about, notice to prevent°from catching a cold to aggravate a condition, under the practice the bed activity should stand a beginning from the bedside and gradually hand a bed to run about, every day 2~3 times, each time 15~20 mins.
2.2 nursings because the surgical operation wound is big, the Ge muscle jacks up and breathes sport to be subjected to a limit, if the sufferer appears a cough and spits out phlegm a difficulty, can give fog turn inhalation, everyday 2 times, fog after turning the inhalation gives to turn over a body in time each time, light Kou back, instruction sufferer hands press press to slice, deep breathing a cough, the encouragement coughs phlegm.
2.3 mental nursings because the surgical operation slices and leads the friction of flowing the tube to produce ache and brings pain and sufferings to sufferer's body, the Zun cures Zhu to give the town the painful pump keep on using, and observe a record to use an efficacy of medicine fruit, can according to sufferer mental state, cultural character carry on mental state to appease and give spirit consolation, set up to win paroxysm confidence.A cough, deep breathing is by hand pressed to press to slice and carefully fixed to lead to flow a tube and prevent°from leading to flow to take care of return the ache caused by ambulation.
2.4 food nursings generally forbid to eat for 3 days, bowel peristalsis instauration after, give to all flow →the half flow →Pu food.Because liver function decrease, have a poor appetite, the nourishment condition is worse, should give nourishment support, when the sufferer can take a meal guide a sufferer to choose some hot quantity, just the right amount high-quality egg white, high vitamin, low fat, low sodium and easy digest food.Little food many meals is basic principles and avoid cold and rigidity food, in fixed time measure sufferer's weight to understand nourishment condition.
2.5 sweep a nursing to flow tube, reservation to lead urine, malnutrition and phlegm liquid because of leading excessive can become the potential danger of infection, should strengthen a skin nursing, use Wen Shui to wipe to wash whole body several times everyday, keep mouth cavity and meeting private parts to sweep, keep bed to sweep aridity, replace bed sheet and sick personnel to take once everyday.Forbid period of food to strengthen a mouth cavity nursing.Change a medicine, cure, nursing, strictly performance have no germ operation regulations, cut off infection path;Keeping each to lead to flow to take care of is lucid, the belly has no male body to advertise for and leads discharge<5 mls, pull out to lead to flow a tube in time, be infected by prevention;Giving repeated advice to sufferer and family members can not at will uncover gauze, by hand the touch slices, in order to prevent pollution.Replace each lead to flow tube, must use sparse tincture of iodine cotton label disinfection, the reasonable uses antibiotics and prevent°froms being infected to take place with control, after closely observing Shu in 5 days the body advertise for:Have have no the issue of blood order, purple Gan and jaundice, observe wound to ooze a liquid and ooze a blood circumstance, monitor a sufferer to wet sugar and wet specific weight and urine quantity.The reasonable arrangement loses a liquid in proper order, bring trouble the diagnosis and treatment provide a dependable basis.
3.Recover from illness a nursing
Sufferer because of liver the leaf cut off, in response to close observation consciousness appearance is a cup too low disorder, ego care the ability lower, personality and behavior abnormality, food forbidden high egg white food, give carbohydrate is lord of food, promise the balance of water, electrolyte and other nourishments.Lie a bed rest to avoid strenuous exercises, sweep a bowel way before the Shu, can reduce the source of blood ammonia, may take place the parts of factor of the liver brain disease after getting rid of Shu, Shu empress intermittent give oxygen for 3~4 days, with protection liver cell, make the blood oxygen saturation degree maintained in above 95%.
In addition, minority of liver leaf resection future trouble because the belly cavity leads to flow Chang can result in liver's creating the partial infection of noodles not, cause after the hair bleed of occurrence, Shu behind may also cause digest way issue of blood, digests a symptom in response to the tight observation sufferer, if vomit, should observe the color and property of vomiting the thing and excrement, do concealed blood to experiment when it's necessary.
4.Hospital discharge health instruction
(1)take a rest and activity:3 month attentions after Shu lie a bed rest and increase hepatic amount of blood, lighten liver burden and is advantageous to liver repair and liver function instauration.Notice Lao Yi to combine, carry on adequacy toughen, such as jogging, stroll etc., avoid a tired and heavy physical strength activity, notice ego protection.
(2)the food adjust a reason:The food is simple elegance, in fixed time metered, just the right amount high-quality egg white, hot quantity, rich food with the vitamin, low fat, avoid eating to fry in oil, cold, mordacity etc. stimulating food, eat fresh vegetable, fruit more, quit smoking wine.
(3)periodical reexamination AFP, liver function, super B, CT etc..
(4)keep an emotion stability, the Chinese medicine thinks "the Nu then harms liver" and as far as possible avoids spirit strain and emotion concussion and keeps mood delectation, with actively optimistic attitude match various treatments and nursing, recover from illness as soon as possible.