Pancreas cancer attends to measure and postoperative _'s prevention and health care

Pancreas cancer attends to measure and postoperative _'s prevention and health care
It is one of the common digestive system malignant tumour, patient's age is at 40- 70 years old more, see more men. Occur frequently on the intersection of pancreas and the intersection of hair and position ' Accounts for 70%- 80%) ,Can present many centres to sow scatteredly, the malignant intensity is high, and difficult to find in early days. The excising rate of operation is low and difficult in order that completely, it is only 5% to excise the survival rate of 5 years after the operation.
[Clinical feature ]
1,Suffer from abdominal pain often in order to first publish symptom, it is the body of pancreas, pancreas end cancer and most common symptom too. Suffer from abdominal pain position in the intersection of middle and upper abdomen, often present continuation, going on aggravation. Cancerous swelling can show as getting obstinate low-back pain later period, brief cancerous swelling on the intersection of belly and wall and the intersection of abdominal cavity and neural clump infringe already.
2,Jaundice obstructive jaundice the intersection of pancreas and the intersection of head and the intersection of cancer and most outstanding symptom, take the form of person who go on, aggravate generally, accompany skin pruritus, the urine is presented densely and dark brown, the stool can present color of potter's clay.
3,Become thin weak caused by cancerous swelling physique consume, lose the appetite and pancreas function insufficient and lasting abdominal pain influence, sleep and have a rest seriously, the patient can present the weight decline rapidly, the evil liquid quality sign of whole body such as being weak that become thin.
4,The intersection of digestive tract and symptom list blockage because of bile and pancreatic juice, enable gastrointestinal disorders of digestion, the patient often has appetite failing, sick, vomits, the abdominal distension and diarrhoea.
5,Persons who obstruct with the biliary tract, serum bilirubin (mainly direct bilirubin) Can increase notably, alkaline phosphatase is raised, some patient empty stomach blood glucose rises, the sugar tolerance test presents the diabetic curve.
6,Pancreas cholangiography of the back run (ERCP) Reveal the pancreatic duct is narrow, with stiff and expanding, cutting off, shifting tube wall.
7,In charge of the radiography (PTC) by the liver and gall of skin Can reveal the bile duct is expanded in the liver, the pancreatic duct is full of defect, cut off, shift, the tube wall is stiff.
[Attend to the measure ]
1,Nursing before the skill
( 1) The psychology is attended to: Assess patient's anxious intensity and cause its anxious, frightened reason; Encourage patients to tell uneasy idea and feeling. The case that enumerates the similar operation to the patient in time, recovers, encourage visiting and looking at each other among the similar operation patients; Strengthen and support the systematic communication and get in touch with relative and his the society at the same time, try hard to help to solve the patient's worry. Teach patients how to lighten the anxious method.
( 2) The diet is attended to: Understand diet and eating habit which the patient likes, make patient's recipe with the nutritionist. The taking food amount of the record, and observe and eat, digest the situation, help and digest medicines according to the doctor's order.
( 3) For having patients who takes in the obstacle, arrange fluid infusion rationally according to the doctor's order, supplement the nutriment, it corrects water, electrolytes, acid to be alkali out-of-balance, etc.
( 4) Infuse albumin, amino acid, new blood, blood platelet,etc. according to the doctor's order, correct low albumen blood disease, anaemia, blood coagulation mechanism's obstacle,etc..
( 5) Monitor liver function, electrolyte, blood coagulation picture,etc..
( 6) Skin care: Every of daily expenses warm water wipe bath 1- 2, wipe behind the bath scribbling, alleviating itching pharmaceuticalling; When present pruritus, can pat with hands, must guard against using and holding in hand; The pruritus position tries hard not to use cleansers such as the soap,etc. clean; It is difficult for pruritus not to bear, influence sleeper, until doctor's order give calm to lull medicine.
2,Postoperative nursing
( 1) Walk pancreas, the intersection of duodenum and person of skill excised, should observe the intersection of abdominal cavity and drainage tube with cigarette, guide in the piece oozing out quantity and propertying of thing closely, watch out for complications such as postoperative gallbladder Lou, pancreatic fistula and abdominal cavity's internal haemorrhage,etc..
( 2) Walk the intersection of pancreas and body and the intersection of pancreas and person who excises tail, should notice, put into drainage tube in the section of pancreas clear, colourless water sample pancreatic juice ooze out. When there is pancreatic fistula, should connect lasting negative pressure of the drainage tube to attract immediately, and scribble and wipe and oxidize zinc ointment to protect and guide the skin around the calibre.
[Health education ]
1,Explain the relevant knowledge of disease, tell the reason which presents pain, introduce and help the method to relieve pain.
2,Introduce the precautionary measures of the fit method, postoperative common and uncomfortable and complication in operation environment, procedure, skill, postoperative and attend to the fit method etc..
3,Explain the reason why jaundice appears and impact on skin, tell the reason that can't scratch the skin hard, introduce the skin self-protection method.
4,Tell the reason of obstacles of mechanisms of blood coagulation, advise and notice self-protection, avoid traumatism,etc..
5,And healthy relation of explaining mood, advise keep mood steady, appropriate rest and doing exercises.
6,Recommend further treating ' Put, chemotherapy,etc.) Meaning, method, it is uncomfortable since curative effect, it is common and the prevention, expenseses necessaries of complication,etc. information.
7,Encourage insisting on treating, follow up a case by regular visits to regularly, find the unusual sign goes to a doctor in time.
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