1.Keeping the gastrointestinal decompression tube open 24～48h after surgery to drain a small amount of blood should be regarded as normal, if a large amount of blood is induced, it should be reported to the doctor immediately for treatment. The gastrointestinal decompression tube should be kept for 3~5 days to reduce anastomotic tension for healing. Pay attention to the accurate connection of the gastric tube, fixed firmly to prevent dislodgement and unobstructed drainage.
2.Close observation of chest drainage and nature of chest drainage fluid If abnormal bleeding, cloudy fluid, food residue or celiac fluid is found, it indicates active bleeding in the chest, esophageal anastomotic fistula or celiac disease, and corresponding measures should be taken to clarify the diagnosis and deal with it. If there is no abnormality, the drainage tube should be removed 1~3 days after surgery.
3.Postoperative care of cardia cancer should strictly control the diet as the esophagus lacks plasma membrane layer, so the anastomosis is slow to heal. During the fasting period, intravenous fluid should be rehydrated daily. If a duodenal drip tube is placed, after the recovery of intestinal peristalsis on the 2nd day after surgery, nutrient solution can be dripped through the catheter to reduce the amount of fluid infusion.
On the 5th day after surgery, if there is no special change in the condition, milk can be fed through the mouth, 60ml each time, every 2hl times, and equal amount of boiled water can be given during the interval, and if there is no adverse reaction, the amount can be increased day by day. On the 10th to 12th postoperative day, change to a dregs-free semi-liquid diet, but care should be taken to prevent eating too fast and too much.
4. Observe the symptoms of anastomotic fistula The clinical manifestations of anastomotic fistula are high fever, rapid pulse, respiratory distress, severe and intolerable chest pain, low breath sounds on the affected side, turbid percussion, elevated white blood cells and even shock.
Treatment principles: (1) pleural drainage to promote lung expansion (2) selection of effective antibiotics to fight infection (3) adequate nutrition and calories. At present, complete gastrointestinal nutrition (TEN) is mostly used for treatment by gastrostomy irrigation, with precise and satisfactory effect.