TACE (transcatheter arterial chemoembolization), hepatic artery chemoembolization. TACE is a technique in which a catheter is inserted selectively into the tumor supplying target artery and then the appropriate amount of chemotherapeutic drugs and embolic agents are injected at an appropriate rate to increase the local concentration of chemotherapeutic drugs in the tumor and occlude the blood vessels so as to achieve the desired therapeutic goal.
What should be done before the operation?
1. Wrist band shall be worn to facilitate identification.
2. Quit smoking and alcohol: to reduce pulmonary and cardiovascular complications.
3.The day before the operation, the doctor will talk to the patient and family members to sign the informed consent form, please do not leave the ward.
4.The day before surgery, you need to prepare the skin (flat umbilicus to the upper third of the thigh), and at night, please do your personal hygiene: such as cutting nails, bathing, washing hair, etc.
5.Fast for 2 hours on the day of surgery (please ask your doctor in charge for the surgery time), please stay with your family, change into a good hospital gown; remove dentures, jewelry, etc. and hand them over to your family for safekeeping.
6.Wait for the notice to take the CT film and be sent to the interventional operating room by the nurse or doctor.
7. Since you can get out of bed and defecate only after 12 hours after surgery, please train to defecate in bed and have a urinal or potty ready.
Post-operative precautions.
1.Your body will be connected to a cardiac monitor to keep track of changes in your condition and to observe your blood pressure, heart rate, pulse and breathing.
2.You need to rest in bed absolutely within six hours after surgery, the nurse will give sand bags to compress the puncture point, the lower limb on the operation side should not be forced, bending, if you feel the operation limb paralysis, dull feeling, please inform the medical staff in time.
3.If blood is found to be seeping from the puncture point, do not panic, please press the bleeding point with your thumb immediately and call the doctor for treatment immediately.
4.No bleeding within 24 hours after the operation, the bedside doctor will remove the bandage for you.
5.Please drink more water to facilitate the discharge of toxins from the contrast agent and chemotherapy drugs.
6.Discharge appropriate activities, pay attention to rest and avoid overexertion; no smoking and drinking.
Treatment of complications: Due to the effect of drugs, you may encounter the following complications after surgery (not necessarily occur) 1. Fever: It is caused by the body absorbing the ischemic necrotic tumor tissue. If the body temperature does not exceed 38.8℃, it usually does not need special treatment, you can drink more water, and it can return to normal in 3-7 days. 2. Gastrointestinal reaction: such as anorexia, nausea, persistent vomiting, abdominal pain, diarrhea, etc.; it mostly occurs in 2-8h after surgery and lasts 2-5 days. Drink warm water with honey on an empty stomach before breakfast and dinner to promote intestinal peristalsis. 3. Pain in the liver area : This is due to postoperative hepatic edema and increased tension of the liver envelope. Please tell your healthcare provider when you are in pain so that you can stop the pain in time.4. Eructation : Less common, associated with drugs or stimulation of phrenic nerve or vagus nerve branches.5. Myelosuppression : Regular blood tests, less frequent visits to crowded public places and prevention of colds.
Dietary regimen before and after hepatic artery chemoembolization
I. Dietary regulation before TACE
The first 3 days start to eat a light and easy to digest diet, to achieve “three high and one low” that is, high sugar, high protein, high vitamin, low fat. Protein is the raw material for liver cell repair and regeneration, sugar provides energy, and vitamins promote normal cell metabolism, so eating more is good for liver protection; fatty, sweet and thick taste is easy to produce phlegm and dampness, and fried and oily products are easy to hurt the spleen and stomach and affect digestive function. Therefore, please eat more fresh vegetables, fruits, lean meat, eggs, milk and various soy products, and less greasy and fried products; avoid eating spicy and acidic, stimulating products. Add some cold foods, such as winter melon, watermelon, rice kernel, mung beans, cucumber, carp, etc., and eat more foods with high fiber, such as celery, spinach, bananas, etc., to ensure smooth bowel movement, which is very effective.
Second, the diet after TACE care
1, the immediate reaction of dietary conditioning
After TACE, patients often experience burning sensation in the upper and middle abdomen, which is due to the inflammatory reaction caused by drug reflux into the stomach and duodenal artery. If there is no obvious nausea and vomiting after the operation, you can eat liquid as early as possible and drink a small amount of cool boiled water or orange juice or root juice, which can not only reduce the burning sensation in the stomach, but also has important significance in preventing the occurrence of stress ulcers.
2.Early reactions to dietary regimen
Early reactions generally occur 1-3 days after TACE, and symptoms such as nausea, vomiting and fever can occur. At this time, eating can not only play a role in protecting the gastric mucosa, but also the correct diet can reduce the symptoms of nausea and vomiting and increase nutrition.
Six hours after TACE, if the patient has mild stomach discomfort and no obvious nausea and vomiting symptoms, he can eat a light and easily digestible semi-fluid diet, such as noodles, vegetable porridge, etc., a small number of meals, but should not enter the nourishing food, to prevent the body more damp heat. If there is obvious nausea, vomiting symptoms, then give ginger juice with water to take warm or oral ginger, plum, etc., until nausea, vomiting symptoms alleviated before eating. After vomiting, gargle and rest for a moment, then eat in small amounts.
Fever is one of the common side effects caused by necrosis and absorption of tumor tissue after embolization, which mostly appears on the second day after surgery and lasts for about 1 week. During this period, food should be mainly cold, and more fresh vegetables and fruits should be eaten, such as tomato and winter melon soup, bitter melon and mung bean soup, etc. Patients should be encouraged to drink more water to speed up the excretion of toxins and achieve the effect of clearing heat and dampness to reduce toxicity.
3, the recent reaction of dietary regulation
With the damage of chemotherapy drugs on the liver, 3-5 days after TACE, patients often begin to appear elevated serum bilirubin and transaminases, which is considered by Chinese medicine to be caused by damp heat in the liver and gallbladder. Therefore, in principle, the diet to clear heat and dampness should be adjusted appropriately. In addition to eating more fresh vegetables and fruits, the patient should eat carp red bean soup, corn beard winter melon soup, barley congee and watermelon, which is known as “natural white tiger soup”, in order to accelerate the body’s dampness and heat from the stool. At the same time, the patient can consume eggs and snail soup with chicken bones and grass, which can help to relieve the liver and gallbladder, reduce dampness and yellowing, and clear heat and detoxification. In order to improve the patient’s resistance, some clear tonic food such as turtle, black fish, wild duck, etc. are appropriately consumed.
Third, the patient after TACE discharge diet guidance
After TACE, due to the suppression of the bone marrow hematopoietic system and immune function by chemotherapy drugs, patients often experience significant weakness, white blood cell decline, and easy to catch a cold. Dietary guidance for discharged patients.
1. Benefit qi and nourish blood to enhance physical fitness. Eat astragalus porridge, jujube porridge, astragalus peanut and pig’s foot soup and other foods that benefit qi and blood.
2, avoid eating greasy, spicy and acidic stimulating food.
3, moderate consumption of green tea, “with the rest of the diet,” it is recorded that tea has a cool liver and gallbladder, remove heat and eliminate phlegm, modern pharmacological research has also proved that green tea has a certain effect on improving white blood cells.
4, eat more sour food, such as orange, yogurt, hawthorn, etc. You can also add vinegar to the dishes in moderation. Chinese medicine believes that sour taste into the liver, has the effect of softening the liver, nourishing the liver, practice has proved that sour food has a certain role in protecting liver function.