It influences the prognosis that the postoperative detail is dealt with

It influences the prognosis that the postoperative detail is dealt with
It influences the prognosis that the postoperative detail is dealt with
The middle and southern surgery of university refined professor of hospital department of general surgery Lu XinSheng in Hunan is the important means to treat. But it all have wound nature the operation and anaesthetizes, can cause the patient to be a series of and surge and react. The surgeon should pay attention to the correct technical operation of the operation, as well as pay attention to various questions initiated by disease, operation and anaesthesia. Stage begins to totally recover after the patient leaves hospital when the operation finishes after the operation. The purpose of the operation aftertreatment is to perform the operation and should surge reflecting to minimise as much as possible, make the patient's physiology and psychological condition basically normal, in order to the recovery of guaranteeing a smooth postoperative patienting. The centre point of the operation aftertreatment is to prevent operation complication one, find in early days and deal with complication in time and reduce emergence and danger of complication as much as possible. It is that complication includes complication that may take place to defend complication after all kinds of operations and special complication correlated to operation way after a centre point operation. The surgeon should understand it in an all-round way, and take the effective precautionary measures. In fact the prevention of complication begins with ShuQian, should find in time and deal with various compatible disease and dangerous factor of bringing out complication actively after performing the operation. Demand to smoke and give up smoking for 6 weeks before patient's skill, can make the complication incidence of postoperative lung reduce from 50% to 10%. The patient who takes aspirin, stop medicines for 10~14 days before the skill, in order to improve the blood coagulation function, prevent the skill and neutralize postoperative bleeding. Instruct the patient how to train the essential breathing function and as meeting the exercise of the postoperative change, including practising defecation and urination, and correct cough, arranging the phlegm method,etc. on the bed. Intervene the psychology, dispel patient's fear of performing the operation, avoid tense and anxious mood. Rigorously enforce operation indication, is chosen the correct operation way, improve and anaesthetize and ease pain; Adopt and achieve the scientific and technological skill outside in the skill a little, treat every step operation carefully conscientiously, reduce and bleed in the skill, adopt " restricted fluid infusion " ,Try not to transfuse blood or transfuse blood few; Strengthen the warm-keeping to the patient in the operation, maintain the normal body temperature in the skill. It is all of great importance that the above prevents the postoperative complication correctly. Postoperative how appropriate should directed primarily to may hinder patient from resuming and bringing out it the factors dangerouses of complication aftertreatment of handling on skilling postoperativelying: Escort patient Ann and return to the ward. After the operation, only if general anesthesia patient if life physical sign steady, should partial to, send back the ward together anaesthetizing doctoring and surgeoning. The general anesthesia patient should send the room to anaesthetizing to recover before waking up, send back to the ward after totally waking up. Special operation and critical patient should send ICU to monitor and deal with. Transport and observe the patient's situation in the course closely, prevent meeting accident. After the patient sends, doctor, nurse escorting it answer and hand over with the operation situation to the patient by the bed of doctor, nurse on duty of the ward,etc. in detail; Measure the life physical sign after reaching, handle the abnormal condition; Check the intersection of infusion and passway and various pipelines ' Trachea intubate, the intravenous intubate of centre,etc.) ; Surgeon should supervise nurse various drainage tubes ' Abdominal cavity's drainage tube, T -shaped tube, various make fistulas, stomach tubes, catheters) Open, connect and guide the bag, and check whether it is unobstructed and observe color and quantity of guiding the liquid. Draw the postoperative doctor's order and write the postoperative record in time. The former, including being attend to the rank while being postoperative, content and time to monitor, the vein inputs liquid and electrolytic kind, quantity and input speed, application of antibiotic, treatment of the special circumstances,etc.. The latter including postoperative discovery and operation of diagnosing, the skill passes; Have already constructed the operation name, the bleeding amount and blood transfusion amount in the skill; Postoperative problem and processing measure,etc. that should be paid attention to. Lie in the location. Should choose to lie in the location according to the patient's whole body state, disease properties, anaesthesia and skill type,etc., make the patient in the comfortable body posture benefiting the activity. Patient, operation of belly, after the general anesthesia totally wakes up, anaesthetize drawn game can adopt low half sit or sleep location or slope lie the location while being getting rough after the several hour outside the hard membrane, thigh and knee joint little song. Like this not only the patient feels comparatively comfortable, but also can reduce the belly tension, benefit the activity of the lower extremities and promote the intravenous reflux of lower extremities. The shock patient should adopt the lower extremities to raise 15~20 degrees, the head and special body posture where the body raises 20~30 degrees. Ease pain. Postoperative pain can be aggravated and should be surged and reacted, hinder the patient's activity and cough. It will cause or aggravate the postoperative complication too to ease pain completely. The doctor should instruct the patient how to pain and tell a nurse in time, and will demand to stop the pain, bear pain instead of being strong. Because the medical personnel afraid the patient anesthetic gets into the habit without easing pain effectively for the patient. Slight the intersection of pain and patient can take orally or inject low dose of the intersection of opium and kinds of stop the pain or non- the intersection of steroid and body medicine; As to large-scale patient behind the operation relatively, can adopt outside the hard membrane holding conduiting, connecting, easing pain pump or patient's automatic control ease pain law relieve pain. Movable to the bed. In principle should let from patient to bed activity as early as possible. Situation allow, should encourage and help the patient to sit by the bed moving the lower extremities in postoperative that night, can from the intersection of bed and activity, increase down the intersection of bed and number of times and time of activity progressively next day. Leave the bed activity help the intersection of lung and the intersection of base and inflation of bottom and improve the lower extremities to circulate. Should notice, results of the activity are different to sit quietly in the chair and leave the bed after leaving the bed. As to unable from the intersection of bed and patient of activity, should encourage and help the patient to stand up, vary the body posture regularly, movable limbs, make, give a piggyback, deeply breathe and cough voluntarily voluntarily and passively. Take food in early days. Discover, it is postoperative early (12~24 hours) The small intestine has already resumed the function, the stomach is 24~48 hours, colon takes 3~5 days. Before the full restoration of the gastrointestinal function, patient's already ability is passed a diet. Propose the general belly operation patient begins to drink the water or enter the diet of liquid on a small quantity in postoperative 6 hours, strive for the totally oral diet of the third day. Eat and can promote the gastrointestinal tract to wriggle in early days, offer nutrition to patient; Can maintain the normal protective screen function of the intestine, prevent intestinal bacterium and endotoxin from shifting, it is the effective measure which prevents the endogenous infection. Antibiotic of rational application. Select antibiotic for use according to patient's situation, and adjust and inactive in time. Prevent abusing, prevent producing and is able to bear the medicine fungus, prevent the dual infecting and fungal infection. Others. Uncomfortable and symptoms such as belly operation hiccup, nausea vomiting, acute gastrectasia, abdominal distension, urine retention incident,etc., should look for the reason and deal with in time. Since extending in the department 1990s outside reading the quick passway, a new surgical idea has risen in countries such as America and Europe,etc., namely fast passway surgery (fasttracksurgery) ,Also express one's gratification and recover in surgery rapidly. It utilizes the existing means to enclose various regular measures of period of operation to improve, optimize and recombinate, abandoning some has no norm or routine which follow the medical basis of the card. Offer good service to patient, and advocate enclosing the operation The intersection of initiative and participation of patient under course, so as to reduce damage of patient, reduce, should defy, react, prevent and reduce, combine while being postoperative while being postoperative? 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