I. Vaccination time
Vaccination can be given 3 months after surgery. If the baby has never been vaccinated after birth (i.e., has not participated in basic immunization), you should choose the best time for the baby’s physical condition 3 months after surgery to receive the supplemental vaccination. If high fever and rapid respiratory heart rate occur after vaccination, the condition should be closely observed and, if necessary, treated by contacting the local pediatrician of pediatrics.
Second, wear a chicken breast control device and use scarring spirit
Most children with congenital heart disease have preoperative augmentation of the precordial area or chicken chest of different severity, and the median incision will make it obvious after surgery; children without preoperative augmentation or chicken chest may also have changes in the median incision after surgery. The sternum can be flattened and fixed with the use of a chicken chest control device to make it grow smoothly and beautifully. In addition, silicone type scar spirit can be used to soften the scar tissue and make the wound more flat.
Precautions are as follows.
1.The chicken breast treatment instrument is started to use after discharge from the hospital and continues to be worn for 6 months.
2.24 hours continuous use, charging 3 times a day for 30 minutes each time.
3.Please tighten the band when you use it (to the extent that the skin is not strangled red, can be stretched into the pinky finger for the appropriate elasticity)
4, the summer heat, can cause prickly heat, eczema growth, can be appropriate to reduce the wearing time, wear the prevention and control instrument should be avoided due to prickly heat leading to skin infections eventually lead to sepsis.
5.Sleep in supine position or side lying position to avoid pressure on chest wound.
6.The scar patch can be used repeatedly and cleaned with cool water, not with hot water or sterilized water. It can be used at the same time with the chicken breast control device, and the scar patch is used for 6-9 months.
III. Review
Purpose of review: To assess the recovery after surgery, adjust the medication, and deal with abnormalities in time.
Explain to the doctor the child’s activity, spirit, appetite, urination and defecation, and whether there is any growth in height and weight. The doctor should pay attention to lung auscultation, heart rhythm, murmur auscultation, liver size, and the presence of swelling. Electrocardiogram, chest X-ray, ultrasound are selected according to the situation, and electrolytes are rechecked with attention to long-term diuretics. If there is suspicion of releakage after atrial defect, arterial catheterization, more severe valve closure insufficiency, pericardial effusion, or long-term high fever with suspicion of endocarditis, ultrasound can be done to clarify the diagnosis.
Discharge with medication.
(1) Generally, children with non-cyanotic precocious heart disease without combined pulmonary hypertension are discharged with medication for 1 month, and the medication can be discontinued after 1 month of review without special circumstances.
(2) Non-cyanotic precocious heart disease combined with pulmonary hypertension children are recommended to take medication for 3 months, discharged with medication for 1 month. 1 month review, according to the situation at the time to adjust the amount of medication continue to use. 3 months can be reduced according to the situation to stop or continue to use medication.
(3) Children with cyanotic precocious heart disease are recommended to take medication for 3 months after surgery, and be discharged with medication for 1 month.
(4) Small doses of aspirin should be taken for half a year to a lifetime after two-way Gleen, total cavity, body-pulmonary bypass, etc., and should not be stopped without authorization.
IV. Diet and activity
1, the amount of activity: generally within 6 months after the operation does not advocate the child to carry out strenuous activities, such as running, jumping, etc.. Those with normal heart function can walk around in front of the bed and behind the house and get some sunshine. For those with poor heart function (large liver, edema, faster respiratory heart rate, poor mental appetite), the amount of activity should be strictly controlled and more bed rest should be given. From 3-6 months after surgery, gradually increase the amount of activity according to the actual situation of the child, but still pay attention to control the activity! When there is unexplained panic, shortness of breath, dyspnea, cyanosis, nausea, vomiting, loss of appetite, swelling obvious should be promptly to the hospital to identify the cause to be treated, never careless!
2, diet: should eat less and more meals (3 main meals and 3 supplementary meals). ＜For children <3 months old, feed mother's milk, milk, rice paste, and take calcium concentrated liver oil drops, fresh fruit juice, vegetable juice, and puree as appropriate. For infants 3-10 months old, gradually add egg yolk (1/4-1/2-1), egg custard, thin porridge, vegetable porridge, crushed noodles, minced meat porridge, etc. Supplementary food can be added with fruit juice, cookies, etc., and reduce the number of milk feedings. for children 10 months old, they should be able to eat noodles, eggs, rotten and crushed chicken, fish, shrimp and vegetables, and small pieces of fruit. Pay attention to nutrition to prevent edema or malnutrition caused by low protein. For those with poor heart function, control water intake appropriately, pay attention to urine volume and color to avoid increasing the burden on heart and lungs. 3 main meals: milk, congee, eggs, etc. for breakfast; lunch and dinner should be mainly high protein and high calorie foods such as chicken, fish, eggs and shrimp, supplemented by fresh vegetables and a small amount of rice and noodles, to seven or eight minutes full. 3 complementary meals: 9-10 a.m., 2-3 p.m., and before going to bed at night. Fruit is the main food, supplemented by good quality cakes, cookies and other foods.
V. Medication: When discharged from the hospital, generally according to the child to bring some cardiac, diuretic, potassium, vasodilator, antibiotics, cough and phlegm, antipyretics, etc.
1.Anti-fever medicine is generally used for body temperature > 38.5℃, and pay attention to increase water intake appropriately after fever and taking anti-fever medicine.
2.When the child has phlegm, in addition to taking phlegm-reducing drugs, the child should be encouraged to cough and expel phlegm by himself. Parents can pat the back to help the child expel phlegm (especially for small infants, note that the hand is bent and hollow when patting the back, and pat rhythmically from the child’s back from bottom to top, and the hand should have certain strength), and if necessary, separate the middle and index fingers and press the trachea several times to force the child to cough up phlegm, which helps to expel phlegm.
3, antibiotic drugs, take 3-5 days according to the situation after discharge, more to take easy to grow thrush (available 2.5% sodium bicarbonate coated oral cavity, mycobacterium tablets finely mixed paste coated oral cavity) or mouth ulcers (can take vitamin C, B2, local spray watermelon cream).
4, diuretics: dihydrocoumarol, tachyphylaxis, butylamine, aminoglutethimide. Take them as prescribed by the doctor and pay attention to the urine volume.
5. Potassium supplements: 10% potassium citrate (local potassium chloride is also available).
VI. Other precautions
Complex malformations such as right ventricular double outlet, transposition of the great arteries and single ventricle are reviewed once a month in the early postoperative period, and the review time can be extended appropriately with postoperative recovery.
When taking diuretic drugs, your child may have dry stools or even bloating and fewer bowel movements. In this case, you should encourage your child to develop the habit of daily bowel movements, eat more vegetables and fruits, drink honey water, and take medication to pass stools if necessary.