Overview of anal fissure
Anal fissure is an ischemic ulcer formed after the fissure of the anal canal skin below the dentate line, whose direction is parallel to the longitudinal axis of the anal canal. It is mostly seen in middle-aged and young people, with perianal severe pain, bleeding and constipation as the main symptoms. Conservative therapy is less effective and prone to recurrence, and surgery is its main treatment. Strengthening clinical care is extremely important to the recovery of patients.
Main nursing problems
1. Pain.
2. Potential complications, such as infection and bleeding.
Nursing measures
1.Psychological care
Patients with anal fissure are affected by defecation pain for a long time, and most of them will have anxiety, tension, fear, pessimism and other bad emotions before surgery. Nursing staff should carefully explain the relationship between constipation and anal fissure to patients, inform patients of the necessity of surgical treatment, in order to relieve patients’ ideological concerns, enhance their confidence in the cure, and make them actively cooperate with the treatment.
2. Preoperative preparation
Before surgery, patients should be carefully asked about their medical history, and routine measurements of respiration, heart rate, temperature, blood pressure, blood routine, liver function, electrocardiogram, coagulation function, chest X-ray, etc. If the patients have symptoms such as coughing, fever, etc., or if the female patients are in the menstruation period, they should report to the doctor in order to postpone the surgery. The patient should be given a low-slag diet for 3 days before the operation, a liquid diet for 1 day before the operation, and an enema the night before the operation.
3. Pain care
Evaluate the nature, degree and duration of pain, and take methods to distract the patient’s attention, such as listening to music or watching TV to relieve pain. Those with obvious pain can be given analgesics as prescribed by the doctor, and observe the efficacy and adverse reactions of the drugs.
4. Wound care
On the day of surgery, you should stay in bed and minimize the activity of getting out of bed. Enhance the inspection, pay attention to check the incision for blood, edema and dressing detachment. Don’t exert yourself or squat for a long time when defecating, and insist on taking a sitz bath after defecation.
5. Bowel care
Control defecation for 1 day after surgery, and then try to keep defecation once a day, drink plenty of boiled water or honey water, to keep the bowels clear and prevent constipation. When constipation occurs, oral laxatives can be taken.
6. Dietary care
Generally, you should eat a liquid diet for 2 days after the operation, and then gradually change to a general diet. Diet should be light, eat more vegetables and fruits, avoid spicy and fatty foods. Encourage patients to drink more water or honey water, or drink light salt water on an empty stomach.
7. Complications care
(1) Bleeding care Closely observe the condition of the wound dressing, if there is bloody secretion in the wound dressing, report to the physician immediately for timely treatment.
(2) Urinary retention Encourage patients to urinate on their own as early as possible after operation. If there is difficulty in urination, measures such as rinsing the perineum with lukewarm water and listening to the sound of running water can be used to induce urination, and catheterization can be performed if necessary.
Health promotion
1. Participate in physical exercise appropriately to promote intestinal peristalsis.
2. Pay attention to nutrition, reasonable diet. 3. Ensure sufficient sleep, pay attention to the combination of work and rest. 4.
4. Keep the bowel clear and develop the habit of regular defecation.
5. If the wound is not healed, take a sitz bath with warm water every day after defecation.
6. If fever, defecation difficulties, perianal localized severe pain, etc. occur, should consult the doctor in time.