What preparations need to be done before surgery
Surgical procedures have certain risks, so it is necessary to make preparations before surgery, such as electrocardiogram, ultrasound, near-infrared ray, molybdenum film, X-ray, liver and kidney function tests, urine, feces and blood routine, etc. The doctor should choose the treatment plan for the patient according to these tests. Therefore, patients should not leave the ward at will after admission to avoid affecting the preoperative examination and delaying the treatment.
Why is skin preparation and skin test performed before surgery
Since surgery requires skin preparation from the concept of asepsis, breast cancer surgical wounds have a large trauma, the skin of the preoperative surgical area needs to be shaved (mainly axillary hair), the umbilicus needs to be cleaned with gasoline and bathed with finger nail clipping to prepare adequate personal hygiene for surgery. Patients who have a history of allergy to penicillin, procaine, etc. should speak to the doctor or nurse to prevent allergy from being tested again.
The significance of postoperative device drainage tube
What is the reason for placing a drainage tube on each side of the affected breast and axilla after breast cancer surgery? Because the lymph nodes in the axilla are removed after radical breast cancer surgery, a large number of lymphatic vessels are broken and lymphatic fluid can accumulate under the skin, and blood can also accumulate under the skin at the same time. Therefore, it is necessary to install a drainage tube and use continuous negative pressure to draw out the accumulated blood and ooze, so that the skin flap is tightly attached to the wound surface, which is conducive to wound healing and prevents necrosis and infection of the skin flap. Therefore, it is necessary to fix the drainage tube after surgery and squeeze it frequently to prevent clot blockage, drainage tube compression and distortion, etc. When lying down, the amplitude of turning should not be too large to prevent the drainage tube from slipping off and to keep the drainage tube open.
Post-operative dietary nutrition needs
After radical surgery for breast cancer, the surgical wound is large, there is a lot of blood and fluid leakage, and the consumption of body fluids is also large. Therefore, proper attention should be paid to the postoperative diet, which is high in protein and rich in vitamins, such as pigeon, cuttlefish, lean meat, etc., as well as a variety of vegetables and fruits, so that the body can recover as soon as possible to promote wound healing and tolerate postoperative adjuvant therapy.
Matters needing attention in chemotherapy stage and toxic side effects of common chemotherapy drugs for breast cancer
Since tumor cells and normal cells lack fundamental metabolic differences, all anti-cancer drugs will inevitably cause damage to normal tissues. The main reactions of chemotherapy for breast cancer are
(1) Chemotherapy drugs can affect the stomach or vomiting center of the brain causing nausea and vomiting.
(2) Adriamycin can cause hair loss and heart damage.
(3) Chemotherapy can inhibit the ability of bone marrow to produce red blood cells, making the patient feel weak, fatigued, dizzy or short of breath.
(4) Anti-cancer drugs affect the hematopoietic function of bone marrow, causing a decrease in white blood cells, as well as easily causing infections in various parts of the body, such as the mouth, skin, lungs and intestines.
(5) Some chemotherapeutic drugs can affect intestinal mucous membrane cells causing diarrhea.
(6) Chemotherapy can directly cause constipation, which may also be caused by the patient’s reduced activity and unreasonable diet structure after chemotherapy.
(7) Cyclophosphamide can stimulate the bladder causing painful urination, urgency, frequency and fever.
Due to the toxic side effects of chemotherapy drugs, more water should be consumed during chemotherapy to reduce the damage of the drugs to the kidneys, and a diet of light and easily digestible food is appropriate. Due to the reaction of gastrointestinal tract, you can listen to music or read some literary books and magazines during chemotherapy to reduce the fear of drugs and relax the brain so as to adjust the tension and ensure the smooth implementation of chemotherapy.
The significance of functional exercise of the affected limbs after surgery
Due to the removal of pectoralis major muscle and nerve in breast cancer surgery, it is difficult to lift the upper limb after surgery, and at the same time, the lymphatic flow is blocked due to the removal of axillary lymph nodes, resulting in edema of the upper limb. Exercise should be started in the early postoperative period, until after the formation of surgical scars, then the exercise effect is poor.
Key points of postoperative functional exercise of the affected limb.
(1) Move the wrist joint 24 hours after surgery;
(2) 1～2 days after surgery (practice simple movements of finger extension and fist clenching);
(3) 2 to 3 days after surgery, practice elbow flexion and wrist flexion and forearm extension and flexion in sitting position;
(4) 3 to 5 days after surgery, touch the ipsilateral ear and ipsilateral shoulder with the affected hand;
(5) 5 to 7 days, practice shoulder lift and flexion shoulder lift to 90 degrees;
(6) 7 to 10 days, practice lifting the affected limb and “wall climbing” exercise, and increase the amount of exercise day by day thereafter;
(7) After 10 days, practice “hoop” exercise several times a day.
Protection of the affected limb after surgery
Postoperative lymph node dissection and lymphatic vessel dissection can block lymphatic flow, and postoperative edema of the affected limb can easily be combined with lymphangitis if not handled properly. Therefore, attention should be paid in normal times to.
(1) No blood sampling and intravenous injection in the affected limb;
(2)Do not lift heavy objects on the affected limb;
(3) Avoid skin breakage and infection of the affected limb;
(4) Avoid mosquito bites.