Postoperative treatment of esophageal cancer and cardiac surgery

By | March 21, 2012

Postoperative treatment of esophageal cancer and cardiac surgery (1) and postoperative care treatment, hospitals should enter the room conditions, at any time on vital signs for monitoring, close observation of patients within 24h after the pulse, respiration and blood pressure changes. 8h after the beginning of every 15 – 30min measuring and recording pulse, respiration and blood pressure once, each subsequent 1 – 2h measuring and recording pulse, respiration and blood pressure again. If the patient pulse, respiration, blood pressure was stable, can be changed to 2 – 4h measurement time, until it is restored to near normal. The patients survive the anesthesia recovery period.
Esophageal and cardiac surgery for treatment (2), often after 2 days from 37.5 – 38DC of the fever, the body reaction is normal after surgery, 4 times a day until body temperature returned to normal.
Postoperative treatment of esophageal cancer and cardiac surgery (3) postoperative chest tube drainage should pay attention to smooth the top of the smooth discharge of pleural effusion, lung expansion as soon as possible. After the first 12h, drainage water column up and down with the breathing, the magnitude is generally 4 – 6cm. Fluctuations or fluctuations in the absence of a small drainage tube may be blocked by blood clot, or cellulose, can be ruled out obstruction drainage tube can be squeezed open. 24 – 36h after the drainage and rarely, if operated side by chest auscultation, breath sounds clear lung X-ray or pulmonary expansion bedside good drainage tube can be removed.
Esophageal and gastric cardia after surgical treatment (4) postoperative day 1 every 6 – 8h to give analgesic pain, so patients can rest and be fully effective cough expectoration.
(5) post-operative nutritional support of patients to pay attention, pay attention to the ratio of various nutrients, provide appropriate calories and protein. Early parenteral nutrition after surgery, taking full advantage of duodenal feeding tube. In general after 2 day, dropping from the nutrient solution duodenal tube 1500, one of the thin milk 1000ml, fruit syrup 500ml. Trickle of early postoperative nutrition by the duodenal tube can promote the recovery of bowel movements. Nutrient solution at the beginning when the slow trickle-down, per minute 20 – 30 drops, the liquid temperature is kept around in the 35DC. If the liquid temperature drops too fast or too low, can cause abdominal pain and bloating, as these symptoms, may suspend or slow down the trickle-down trickle-down speed. 48h later by a duodenal tube can trickle all the nutritional liquid, the total daily 3000, one of the thin milk 1000ml, juice 1000, adding glucose or normal consumption of sugar 100g, chicken soup or broth 1000, adding the appropriate amount of salt. Duodenal nutrient infusion tube from the liquid, not only economic but also nutrition, the patient has no pain, and promote functional recovery of the gastrointestinal tract, and prevent against surgery of gastrointestinal dysfunction or bacterial translocation. And guidance by health care workers, family members, accompanying persons who can drop their own preparation. Day 4 after a small amount of residue-free liquid test meal, eating the first patient, poor appetite, some patients are not used to drinking milk, broth and other high-protein high-fat foods. Dietitians should be based on the patient condition is formulated enteral nutrition diet. Daily oral feeding of patients, the shortfall drops still duodenal tube. 7 days after surgery if the patient eating well, no anastomotic complications, duodenal tube can be removed, to the whole amount of liquid, two weeks to a semi-liquid diet.
(6) to encourage patients to cough, expectoration, good back care, regular shoot back, to help expectoration. When patients cough chest incision hand press to reduce the pain, the patient can do to facilitate a strong cough expectoration.
(7) to encourage patients to early activity, after 2 days may allow patients to sit up in bed to help technical side of the upper extremity activities. Day 4 if no abnormal changes, appropriate activities can be away from the bed, and do deep breathing exercise should be regular, day 7 incision suture removal. If no complications, was discharged after 14 days to recuperate.
(8) application of antibiotics: postoperative routinely given antibiotics to prevent infection. General use of 5 – 7 days, when the body temperature returned to normal after the withdrawal.
Postoperative treatment of esophageal cancer and cardiac surgery (9) should be ready to do postoperative chest X-ray examination and esophageal collar meal examination, in order to understand the situation and chest and anastomosis, to prepare for postoperative follow-up reference.

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