Rectal cancer itself is a lifestyle disease, and patients should pay more attention to improve their poor lifestyle habits after surgery to improve the quality of life and minimize the recurrence of rectal cancer. This article mainly introduces the post-surgical care, diet adjustment and mind regulation of rectal cancer patients.
1.What should be noted in postoperative observation?
Gallbladder is a very important digestive organ and immune organ of human body, and it plays the role of regulating the pressure in the bile ducts inside and outside the liver and maintaining the balance of fluid mechanics in the bile ducts, so it occupies a very important position in human body. It is not just a simple bag that can hold bile as people think, it can store some bile, without it bile is still discharged to the duodenal cavity to participate in digestion, which is a great misunderstanding! So, what are the important functions of gallbladder?
After surgery, patients will be given low-flow oxygen, cardiac monitoring and oxygen saturation measurement, and medical personnel will pay attention to the patient’s respiratory heart rate and oxygen saturation to keep the airway open and prevent respiratory complications. At the same time, the medical staff will also explain the patient’s companion to briefly check the above indicators and inform the medical staff in a timely manner. When the patient was not awake, he was placed in a flat position and given a semi-recumbent position after the operation to facilitate the absorption of exudate, and the patient was mobilized to turn more often to promote the recovery of intestinal motility and to get out of bed early to prevent intestinal adhesion healing and the key to postoperative recovery.
After the operation, pay attention to observe the exudation of incision dressing, pay attention to protect the abdominal wall incision and observe whether there is abdominal pain, abdominal distension, abdominal enlargement and other abdominal conditions. At the same time, observe the amount and nature of drainage fluid, keep the drainage tube unobstructed, avoid distortion and pressure, if the amount of drainage fluid is large and bright red, it should be promptly reported to the doctor for treatment. After abdominal surgery, patients are afraid to cough or cough weakly because of pain or poor physical strength.
In order to prevent the occurrence of this complication, we should tell patients the importance of coughing after surgery, actively encourage and assist them to cough and excrete sputum, turn and pat their backs once every two hours after surgery to help them excrete sputum, and for those who need a permanent artificial anus in the abdominal wall, we should explain in detail to patients before surgery the necessity of an artificial anus for treatment, so that patients will have some psychological preparation to face the reality and accept the fact, and build up confidence to live bravely.
If you have an abdominal fistula, wash the fistula with saline every day and put oiled gauze around the fistula, pay attention to the color of the fistula and the surrounding skin when cleaning; protect the skin around the fistula to reduce the irritation of intestinal fluids and eczema, and often use zinc oxide ointment or moist burn cream to protect it. At the same time, the artificial anal bag should be changed and cleaned in a timely manner to prevent fistula infection. Patients and their families should master the method of changing the pouch so that they can take care of themselves after discharge. Pay attention to the presence of abdominal distension, abdominal pain, artificial anal stenosis or defecation difficulties, and inform the medical staff of any abnormalities in a timely manner.
2.Rational diet after surgery.
The diet of rectal cancer patients in the early postoperative period should be started under the guidance of medical personnel. Nutrients in food can promote the repair of traumatized tissues, help wound healing and postoperative recovery of the body, shorten the course of treatment and timely replenishment of nutrients play an important role in postoperative recovery of rectal cancer, some patients are afraid of defecation and dare not enter the diet, so that the body does not have enough nutrients, which affects the growth of granulation tissue and is not conducive to the healing of incision.
In addition to eating some highly nutritious and easily digestible soft food, the principle of dietary conditioning should be from less to more, from thin to thick, from simple to varied, with low residue and non-stinging light diet as the mainstay, to minimize the amount and number of stool discharge in the early stage after surgery. The diet should be moderate, 3 to 4 meals per day, in order to be comfortable after eating. In addition, ileostomy patients, because the reabsorption of water and inorganic salts is affected after colonic resection, which easily leads to water and electrolyte balance imbalance, should pay attention to replenishing water and inorganic salts, especially in hot weather and when they sweat a lot.
If the patient’s fistula is in the abdomen, the patient should avoid eating properly in order to reduce exhaustion, odor, and keep the stool unobstructed. If the patient is accompanied by diabetes, cardiovascular disease and other diseases that require special control of the diet, one should not eat too much; second, avoid tobacco and alcohol; third, avoid chili, buckwheat, pepper, curry, coffee, pepper and other irritating foods, should be low residue, non-irritating food, pay attention to the reasonable combination of diet and nutrition, and eat more fresh green leafy vegetables;
Four avoid eating easy to make frequent and gas-producing food, such as dry beans, potatoes, onions, asparagus, cabbage, chocolate, unripe fruit, they can produce a lot of hydrogen sulfide, indole and methane gas in the intestinal bacteria corruption, fermentation, etc. cause abdominal distension, frequent exhaust, odor; drink a lot of bicarbonate drinks and lime, beer will produce more carbon dioxide, will also cause increased exhaust, should be avoided; avoid eating easy to Avoid eating foods that are prone to severe odor, such as fish, onion, garlic, raw radish, raw onion, raw garlic, should be avoided;
Avoid eating foods rich in coarse fiber, such as celery, wild rice, onions, leeks, bamboo shoots, soybean sprouts, taro, dried fruits and peels and other high-fiber foods, due to the high content of fiber, fiber is coarse, excretion, easy to cause mouth obstruction, should be avoided or reduced; avoid eating “hair”, the trial showed that the incision infection rate in the control group significantly lower than the non-control group. Hairy things” meat category: pig head, chicken head, shrimp, crab, mutton, rooster, dog meat; vegetarian category: ginseng, antler, pumpkin, bamboo shoots, buckwheat, etc.;
Spices include: onion, ginger, garlic, chili, pepper, etc.; avoid cancer-causing and cancer-promoting foods, such as: doughnuts, fried pork chops, burnt meat, fish, roasted chicken, roasted duck, baked pancakes, yams, cured sausages, ham, salted fish, salted meat, pickled vegetables, smoked meat, fish, soy products, etc. Do not eat too hot, too hot food.
As a result of dry stool is not easy to discharge, you can give patients to increase some fresh vegetables, fruits, moderate increase in some foods containing more vegetable fats, such as sesame, walnuts, bananas, etc., appropriate increase in water intake, such as not getting the expected when the effect of defecation, then you can take a small amount of sesame oil with boiling water before bed or the next morning fasting honey water. Alternatively, take moisten down drugs such as marijuana pills, niuhuang detoxification tablets, etc., reasonable diet, plus appropriate drug treatment, can promote defecation. If it has been embedded, use paraffin oil 100ml orally, or warm saline irrigation; if it still can not defecate, should seek medical treatment.
If diarrhea is frequent after surgery, first of all, attention should be paid to dietary hygiene and the temperature of food. Secondly, you should eat light and easy to digest food, you can eat some astringent chest anti-diarrhea food, such as amaranth, yam, jujube, umeboshi, etc., with drug treatment, generally can be obtained to stop diarrhea, restore the efficacy of normal defecation.
A small amount of postoperative bleeding can be eaten foods with hemostatic and astringent properties, such as lotus root slices, lotus root, lotus seeds, eggplant, fava beans, etc. Large amount of bleeding, surgical treatment. If the amount is large, seek prompt medical attention.
For patients who need to do chemotherapy, chemotherapy before the patient is asked not to eat spicy food, can reduce the gastrointestinal tract reaction, chemotherapy during the diet is best to avoid the peak time of the drug, such as intravenous chemotherapy drugs, it is best to fasting, because through the intravenous to high concentrations of chemotherapy drugs may have nausea, vomiting, fasting can make nausea and vomiting symptoms reduced.
If you take chemotherapy drugs orally, it is better to take them after meals, which can greatly reduce the stimulation of the stomach. When chemotherapy appetite is often poor, and there are gastrointestinal reactions, it is required to eat more meals than usual, do not eat bananas, walnuts, eggplant and other foods that can aggravate nausea, vomiting reaction, it is appropriate to eat thin and soft, easy to digest food. You should not lie down immediately after the meal. If you still have nausea and vomiting, you can breathe deeply and massage your abdomen; or chew ice chips until the symptoms disappear; you can also drink a small amount of soda, eat a small amount of bread and cookies.
3. A good state of mind helps postoperative recovery.
Modern immunology believes that negative mental symptoms of tumor patients will reduce the immunity of the body and affect the efficacy of tumor patients. Psychological intervention for rectal cancer patients can significantly improve the negative mental symptoms of rectal cancer patients, which in turn can improve the therapeutic effect. First of all, rectal cancer patients should be relieved of their blind fear of tumor, and during hospitalization, they should be familiar with ward environment, living system, related medical care, procedures and precautions, and cooperate with doctors to explain problems related to rectal cancer, so that rectal cancer patients can have objective understanding of the disease they are suffering from and enhance their trust in medical and nursing staff;
Initially establish confidence in overcoming tumor, patients who may undergo mile’s surgery should also be introduced to communicate with patients who have undergone stoma surgery to reduce their worries. Patients with anxiety are often accompanied by nervousness and anxiety, with difficulty in paying attention, poor memory, sensitivity to sound, light and other stimulus factors. They are easily irritated and often have distorted judgments about the meaning of events due to excessive tension and wariness. Therefore, when explaining their condition, they should start from shallow to deep and avoid stimulating rectal cancer patients.
Some practices and opinions of patients should be affirmed and encouraged in time, and those patients who are fearful, irritable and uncooperative should be understood. Cooperate closely with medical staff to build up patients’ confidence in the effect of surgery, and demonstrate in detail the use of artificial anal pouch after surgery to make patients adapt to the abdominal wall stoma in place of anus as early as possible.
4.Chinese medicine conditioning
Rectal cancer belongs to the category of “locked hemorrhoids” in Chinese medicine. The “Suwen” chapter says that “the small intestine moves heat in the large intestine, for the consideration of the obstruction, for sinking.” The cause of rectal cancer was firstly proposed. The disease is described as follows: “Locked anus hemorrhoids, inside and outside the anus like bamboo joints locked, shaped like jellyfish, urgent and then heavy, stool and feces thin and flat, sometimes flowing foul water -…”.
The formation of the rectum is considered by the Chinese medicine to be a tumor caused by the accumulation of dampness and heat in the intestines. The main reason for this is that it is not only the cause of the disease, but also the cause of the disease, which is the lack of vital energy and the deficiency of the spleen and kidneys. Therefore, most of the doctors treat rectal cancer from damp-heat and fire toxin, and treat rectal cancer from the evidence of deficiency.
The prevention of recurrence and late stage colorectal cancer is one of the key points of Chinese medicine treatment. Patients with late stage colorectal cancer have deficiency of qi and blood and are often malignant.
Combining with patients’ physical condition, etiology, disease duration and clinical manifestations, Chinese medicine classifies rectal cancer into five types of treatment: qi-blood stagnation, damp-heat and toxicity, qi-blood deficiency and spleen-kidney yang deficiency. In recent years, various doctors have been treating rectal cancer with different focuses and have achieved better results, such as Bai Tou Weng Tang plus flavor, Phlegm detoxification soup, Silica detoxification soup, Wen Yang detoxification soup, Yin detoxification soup, etc.; there are also many Chinese patent medicines, such as Bo Er Ning capsule, Jin Long capsule, Jin Ke Huai Er granule, etc.; external treatment of Chinese medicine also includes Chinese medicine enema, external application and external washing, local injection formula, etc.