1. Preoperative examination.
(1) X-ray (optional): i.e. chest frontal and lateral radiographs, which can help determine the site, size, scope and its nature of the lesion.
(2) Chest enhanced CT (mandatory): it can show the outline and internal structure of the lesion, the mediastinum, the lymph node enlargement in the hilum, etc. CT scan can show the hidden parts of the lung and is better than X-ray.
(3) Sputum cytology examination (optional depending on the situation): shed cancer cells can be coughed out with sputum, and sputum is an effective method for early diagnosis of lung cancer, with a positive rate of more than 80%. The method is: repeatedly coughing gently after gargling in the morning, and then coughing up sputum from the deep part of the lung with force. It should be noted that the sputum must be coughed out from the trachea of the lungs, and saliva and nasal mucus should not be mixed in the test.
(4) Bronchoscopy (mandatory): It has a high positive rate for the diagnosis of central lung cancer and can directly observe local tissue changes locally, perform biopsy, and send pathological sections for tissue typing. To understand the situation in the trachea and bronchial lumen before surgery.
(5) Blood tests (mandatory): routine blood, coagulation function, blood type, biochemistry (1 + 4), complete set before transfusion.
(6) Pulmonary function (mandatory): check ventilation and air exchange function
(7) Electrocardiogram (mandatory): we can diagnose irregularities of heart rhythm and morphological changes of the heart caused by various heart diseases by electrocardiogram.
(8) MRI of the head or enhanced CT and enhanced CT of the abdomen (mandatory): to determine whether the cancer has metastases in the head and abdominal organs
(9) Bone scan (mandatory): to understand whether there is tumor metastasis in the bones of the whole body, and to add MRI locally if necessary.
2.Pre-operative preparation.
(1) Respiratory training: the patient should be in sitting or semi-recumbent position, relax the whole body, inhale deeply, and then exhale slowly. Do this 30-50 times a day in the morning, afternoon and evening to increase lung ventilation.
(2) Effective coughing: The patient takes a sitting or semi-recumbent position, relaxes the shoulders, leans forward, takes 2-3 deep breaths and then inhales as deeply as possible, holds the breath for 1 to 2 seconds, opens the mouth and throat at the same time, makes a maximum cough with the force of the chest and abdomen, and the coughing sound vibrates out from the chest. It should be noted that effective coughing after surgery does not affect wound healing. To reduce pain caused by pulling the wound when coughing, you can press the wound with your hand or pillow
(3) Quit smoking and alcohol: Quit smoking for at least 15 days, the risk of surgery and the risk of the surgery
(4) Psychological preparation.
(1) do self-adjustment, can chat with friends and relatives, relaxation, to minimize tension
(2) Open thoracotomy generally uses posterior lateral incision, long incision, intraoperative propped up ribs, postoperative coughing chest tube stimulation will cause strong pain, although there are a variety of pain relief methods, but no postoperative pain is impossible, so patients should be prepared to bear the pain psychologically before surgery
(3) Open-heart surgery will destroy the negative pressure in the chest cavity, and postoperative lung reopening requires the patient’s efforts, and coughing and sputum removal is a necessary means, as patients we should establish the awareness of self-exercise to promote recovery
3.What are the preparations one day before surgery
(1) Skin preparation: The nurse will shave the body hair in the operation area according to the operation method to prevent incision infection.
(2) Diet: three normal meals can be eaten
(3) Blood distribution: 4-6 ml of venous blood will be taken and sent to the blood bank for intraoperative use.
(4) Training bed urination and defecation: postoperative patients need to defecate in bed because they carry closed chest drains, and toileting is unchanged. The change of defecation posture will affect the discharge of urine and feces, so the day before surgery, patients should prepare a potty or potty, contact bed urination and defecation, in advance to adapt
(5) Enema (optional application): The night before surgery, the nurse will inject a glycerin enema through the anus to laxative and prevent postoperative abdominal rise
(6) before entering the operating room patients should take off all their own clothes, clean patient clothes and change down glasses, dentures, hair clips, watches, jewelry, etc. to family members for safekeeping, such as hand C can not be removed need to be wrapped with bandages
(7) Sleep: Ensure good sleep to meet the surgery in a good mental state. If you find it difficult to fall asleep, you can take Valium tablets to help you sleep.