Common sense of care after surgery for glioma

Intracranial tumors account for about 2% of the whole body tumors, among which 15%-20% are in children, while 20-30% of other malignant tumors will eventually be transferred into the skull. Due to their infiltrative growth, once they occupy a certain space in the skull, regardless of their benign or malignant nature, they are bound to raise the intracranial pressure and compress the brain tissue, leading to central nervous system damage and endangering patients’ lives. Intracranial tumors can occur at any age, but in children, tumors in the posterior cranial fossa and midline are more common, mainly medulloblastoma, astrocytoma, craniopharyngioma and ventricular meningioma. In adults, gliomas of the cerebral hemisphere are the most common, such as astrocytoma, glioblastoma, ventricular meningioma, followed by meningioma, pituitary tumor, craniopharyngioma, neurofibroma, cavernous hemangioma, and cholangioma. The treatment of glioma has also become a problem for many patients. The current treatment for glioma is a combination of surgery, radiation therapy and chemotherapy. The reason for fever and hyperthermia after glioma surgery may be that the hypothalamus was damaged during surgery, causing thermoregulatory dysfunction. In the early postoperative period, the temperature should be measured once every 4 hours to control the temperature below 38C. If the patient’s temperature exceeds 38C, active and effective cooling measures should be taken, such as alcohol bath at the aorta, head placement of ice cap, ice pillow, frozen infusion, electric ice blanket, etc. If necessary, oral antipyretic drugs can also be taken. Disorders of consciousness are mainly caused by damage to the lower thalamus or increased intracranial pressure. The causes of increased intracranial pressure include postoperative blockage of the aqueduct by blood clots, subdural hematoma or epidural hematoma caused by incomplete surgical hemostasis, secondary cerebral edema caused by surgical stimulation or electrolyte disturbance, etc. In the observation care, we should pay close attention to the change of mental state, observe the expression and posture of the patient, and wake up the patient regularly to make simple conversation through language stimulation, especially to observe whether the patient has nausea, vomiting and increased wound tension, neck straightness and other symptoms within 72 hours after surgery, keep the drainage tube open, and pay attention to the color and amount of drainage fluid. Once seizures are detected after glioma surgery, the first step should be to lift the airway obstruction. Keep the airway unobstructed, and at the same time give sufficient oxygen to prevent brain tissue hypoxia. The patient’s head should be tilted to the side to prevent asphyxia due to accidental aspiration of vomit. For increased secretions in the trachea, adequate suctioning should be performed. For those who have urinary or fecal incontinence, the bed sheets should be changed in time and the bed should be kept clean and tidy. The main purpose of radiotherapy is to prevent or prevent the recurrence of glioma. The main purpose of radiotherapy is to prevent or control tumor recurrence. Glioma almost always recurs in situ, and whole brain irradiation has no significant effect on improving prognosis; local irradiation is at least as effective as whole brain irradiation, so currently, irradiation to the tumor area is mostly used to avoid the adverse effects of whole brain irradiation on normal brain tissue. Radiotherapy is more advantageous for tumors with complex anatomical structures, further improving the local control rate of tumors and reducing the incidence of complications that endanger organs and normal tissues.