Post-operative recovery guidance for patients with tuberculosis

  Tuberculosis is a systemic infectious disease, and the causative agent is Mycobacterium tuberculosis. It can infect the skin, mucous membranes, esophagus, gastrointestinal tract, chest cavity, abdominal cavity, lungs, liver, pericardium, bones and other tissues and organs, resulting in tuberculosis lesions in the corresponding areas. Due to the availability of effective anti-tuberculosis drugs, most TB patients require only comprehensive medical treatment to achieve satisfactory results and do not require surgical procedures. The proportion of tuberculosis patients requiring surgical treatment is small, about 10%, and the common ones are lymphatic tuberculosis, tuberculosis spheres, chronic tuberculous abscess chest, tuberculosis combined with bronchopleural fistula, tuberculosis combined with hemoptysis, tuberculosis cavity combined with Aspergillus infection, chest wall tuberculosis, tuberculous self-exfoliating abscess chest, etc. The number of tuberculosis patients requiring surgical treatment is generally decreasing in recent years. Because of the poor resistance of tuberculosis patients, the long healing time of postoperative incision, and the easy spread and recurrence of tuberculosis lesions, the postoperative recovery of patients is different from that of other diseases, and based on years of clinical experience in surgical treatment of tuberculosis diseases, we have prepared the following recommendations for the reference of patients and their families.  1. Treat as much as possible according to the recommendations of the physician in charge. Since tuberculosis is a systemic disease and the tubercle bacilli are slow-growing, resistant, and easily resistant to drugs, the principles of tuberculosis chemotherapy must be observed for effective anti-tuberculosis treatment: early, regular, full, adequate, and combined. Since no new anti-tuberculosis drugs have been introduced in the past 50 years, the main anti-tuberculosis drugs are still a limited number of clinically used drugs such as isoniazid, rifampin, ethambutol and pyrazinamide. Because many patients do not understand the current status of anti-tuberculosis treatment, they often take drugs irregularly and change the variety and dosage of drugs at will, leading to a gradual increase in the number of patients with drug-resistant tuberculosis in recent years. Therefore, we recommend not to change the treatment plan easily once it has been determined. In particular, it is best to communicate with your physician in charge after discharge, and it is best to have the results of your review reviewed by your physician in charge so that he or she can be kept informed of changes in your condition and adjust your medication regimen in a timely manner to achieve good treatment results.  2. Nutritional support therapy has an irreplaceable role in anti-tuberculosis treatment. Surgery is both a means of treating tuberculosis and inevitably causes trauma to the patient. Nutritional support is indispensable for postoperative recovery of patients to fight against TB infection and to recover from surgical trauma. Since most patients with tuberculosis suffer from malnutrition or nutritional imbalance, it is especially important to strengthen or balance nutrition for postoperative patients with tuberculosis, so we recommend ensuring the quality of the patient’s diet after the gastrointestinal tract function returns to normal after surgery. The quality of the diet refers to the variety of food, which is easy to digest and nutritious. Home-cooked meals such as eggs, lean meat and millet rice are good. The quantity of food refers to the amount of food eaten. Quality and quantity, we especially emphasize the role of quantity, if the quantity is not enough, the quality is good, the effect is limited. Therefore, patients are encouraged to eat small amounts several times a day, up to 6-8 times a day, keeping the total amount at 1.5-2 times the usual intake, and emphasizing the importance of bedtime intake, patients are advised to eat at least two eggs before going to bed. Weight gain is a reliable indicator of the patient’s improved nutritional status, and no weight gain or continued weight loss indicates that the patient’s condition is unstable and the chances of relapse increase.  3. Adjust your mind and avoid mood swings. Trust your doctor, TB can be controlled and/or cured. Treatment of tuberculosis disease is different from ordinary bacterial infections. Common bacterial infections are treated with sensitive antibiotics for 1 week, but the reproduction cycle of tuberculosis bacteria is longer, and it takes 3 months of continuous regular treatment to judge the effect of treatment. Bad mood and irritability will not do any good for disease recovery, but will aggravate the disease. In our clinical work, we found that many patients were in good health before the disease, but due to emotional factors such as loss of love, divorce, stressful life and work, mental tension, etc., the organism resistance was low and TB infection appeared. After the operation, we should avoid bad stimulation, adjust our mindset and keep a comfortable mood.  4.Ensure sufficient rest and good sleep. The recovery of disease is inseparable from good rest. Heavy body load and labor intensity can be avoided for most postoperative tuberculosis patients, but good rest and sufficient sleep are neglected by many people. Taking care of children, cleaning up the house, working in less tiring jobs, playing cell phones late into the night, playing games, reading and studying, preparing for exams, preparing for promotions, watching football games, catching up on dramas, etc. are not conducive to the recovery of patients. Rest and good sleep, put the restoration of physical health in the first place, other things to make way for health.  5, the couple’s sex life should be moderate. Tuberculosis patients generally have poor body resistance, and post-operative patients have poorer resistance, so sex between husband and wife is not only detrimental to the recovery of the disease, and may even make the disease worse. We recommend that at least six months after surgery, we should avoid sex as much as possible, and after six months, we should control sex according to the recovery of the body to avoid aggravation or recurrence of the disease. As a family member, we should fully understand the patient’s physical condition and cooperate with the treatment.  6. Pay attention to safety and avoid trauma. During the treatment period, try to avoid trauma, even minor trauma may lead to the spread of tuberculosis to the injured area, resulting in tuberculosis lesions in the injured area, especially susceptible to bone tuberculosis.  7.Discard bad habits and develop good living habits. Smoking, drinking, staying up late, working night shifts, not resting after night shifts, continuing to work, being too busy to rest, playing computer games late into the night, picky eating, not eating properly, etc. seriously affect the resistance to the disease and increase susceptibility to the disease, which can easily aggravate or relapse the disease for patients under anti-tuberculosis treatment.