I. Preoperative care Assist in abdominal plain film and intravenous pyelogram to understand whether there are bilateral ureteral disorders.
Intestinal preparation 1. 5 days before surgery, enter a diet with less residue, 2 to 3 days before surgery, and 1 day before surgery, fasting.
2.Take metronidazole 0.2g orally 3 times a day 3 days before surgery as prescribed by the doctor.
3.Orally take laxative in the afternoon of the day before surgery as prescribed by the doctor.
4.Clean enema in the evening and morning before surgery.
5.Follow the doctor’s prescription for nutritional support treatment. 6.Strengthen psychological care and enhance confidence in surgery.
Postoperative care Ileal bladder tube and bilateral ureteral stent tubes were connected to drainage bags, and the color of drainage fluid was closely observed, and the drainage flow and total 24h volume were recorded respectively.
For gastrointestinal decompression, pay attention to the color, nature and amount of fluid aspirated from the gastric tube, and fix the tube properly, keep the negative pressure suction open and keep records.
For pelvic latex tube connected to negative pressure drainage, keep the drainage open and make good observation.
For ileal substitution bladder or sigmoid substitution bladder surgery, fast for 2 days after surgery, and wait until the gastric tube is removed and the anus is exhausted before eating.
Observe the color of the papilla at the bladder substitute stoma. The ileal bladder tube is usually removed 2-3 weeks after surgery and replaced with a urostomy bag to observe any leakage. Keep the area clean, dry and instruct the patient to use the urostomy bag correctly.
Drugs that promote recovery of bowel movement, such as neostigmine, are prohibited after surgery to prevent damage to the ureteral anastomosis.
Pay attention to the changes in vital signs; changes in abdominal signs, such as abdominal distension and abdominal pain, etc., and timely detection and treatment of intestinal obstruction, intestinal leakage and other complications.
3. Health guidance 1. Instruct patients to learn to use urostomy bag and keep local cleanliness.
2.Directions on diet and rest, change bad habits.
3.Regular re-examination.