Pre-operative care of esophageal cancer 1. Psychological care Patients with esophageal cancer have progressive swallowing difficulties, are increasingly thin, have poor tolerance to surgery, lack confidence in treatment, and at the same time have a certain degree of fear of surgery. Therefore, patients should be explained, comforted and encouraged according to their psychological state, and a fully trusting nurse-patient relationship should be established to make patients realize that surgery is a thorough treatment method and make them happy to accept the surgery. For those who can still eat, a liquid or semi-liquid diet with high calories, high protein and high vitamins should be given. For those who cannot eat, water, electrolytes and calories should be supplemented intravenously. For patients with hypoproteinemia, blood or plasma protein should be transfused to correct it. 3. Gastrointestinal preparation ① Pay attention to oral hygiene ② Preoperative placement of gastric tube and duodenal drip tube ③ Preoperative fasting, with food retention, preoperative evening rinsing with isotonic saline esophagus, which is conducive to reducing tissue edema, reducing the incidence of postoperative infection and anastomotic fistula ④ For those who intend to perform colonic substitution for esophagus, preoperative care must be prepared according to colon surgery, see preoperative preparation for colorectal cancer. 4. Pre-operative exercises to teach patients deep breathing, effective coughing, sputum evacuation, bed defecation and other activities. Postoperative care for esophageal cancer 1. Actively do mental regulating care, encourage patients to face the disease courageously, learn to relax themselves, treat the symptoms that may appear or have appeared correctly, such as pain, unpleasant cough, difficulty in eating, etc., and show perseverance to cooperate with doctors’ treatment. 2. Pay attention to changes in the patient’s body temperature, breathing, pulse and blood pressure, and prevent colds and co-infections. 3. Instruct and help the patient to cough and excrete sputum on the 1st to 2nd postoperative day to avoid weak cough, poor sputum excretion and retention of secretions, which may cause pulmonary atelectasis and pulmonary sensation. 4. If the patient develops high fever, chest pain, dyspnea, rapid heart rate, etc., the patient must report to the physician immediately, and the formation of anastomotic fistula should be highly suspected. 5. The color of the patient’s chest drainage should be closely observed. If the color is milky or yellowish, celiac disease should be highly suspected. 6. If the patient shows panic, shortness of breath, chest pain, irritability, and decreased blood pressure, the occurrence of acute gastric dilatation should be highly suspected. 7. Postoperative fasting is usually 4 to 5 days. If the condition improves and the patient is hungry, avoid eating cold and hard food to avoid life-threatening obstruction and perforation of the anastomosis site. 8. Pay attention to oral care
Drink a little salt water to rinse the mouth and esophagus after each meal to remove accumulated food and mucus to avoid food residues staying in the mouth, leading to bacterial growth and reproduction and the formation of stomatitis; or to prevent esophageal mucosal damage infection and edema. If the patient cannot gargle, the family should dip a cotton ball in saline or cold boiled water to wipe the mouth and teeth. 9. With the remission of the disease and the improvement of the general functional condition, the patient should be encouraged to exercise properly, walk, walk slowly, play tai chi, do deep breathing, etc.