At present, surgical resection is still the first choice for the treatment of liver cancer. Especially in patients with early liver cancer. Chemotherapy should be given after operation to reduce the chance of postoperative recurrence. If conditions permit, transcatheter arterial lipiodol chemoembolization will be more effective. Some biological response regulators and traditional Chinese medicine should be given after operation. Surgical treatment is the first choice for liver cancer, and complete resection of tumor tissue can achieve the goal of cure. With the development of modern liver surgery technology, tumor size is no longer the key factor restricting surgery. Whether the tumor can be resected or not and the curative effect after resection are not only related to the size and quantity of the tumor, but also closely related to liver function, degree of cirrhosis, tumor location, tumor boundary, capsule integrity, venous tumor thrombus and so on. Patients undergoing surgical resection generally require good physical condition, that is, there are no organic lesions in important organs such as heart, lung and kidney, and the liver function is normal or close to normal. Specifically, they need objective evaluation indexes of liver function reserve, such as jaundice level, albumin level and indocyanine green retention rate. And there is no extrahepatic tumor metastasis and the tumor site is limited, rather than multiple or diffuse distribution. The one-year survival rate and five-year survival rate after surgical resection of early liver cancer are above 80% and 50% respectively. If combined with postoperative comprehensive treatment, better results can be obtained.
Guiding opinions:
1, respiratory care: due to surgical trauma, diaphragmatic elevation, respiratory activity is limited, patients have difficulty in coughing and expectoration, and can be given atomized inhalation. After each atomized inhalation, turn over in time, pat the back, and instruct patients to press the incision with both hands, take a deep breath and cough. Encourage expectoration. 2, diet care: generally fasting for 3 days, after the recovery of intestinal peristalsis, give half a full stream and a general food. Because of the decline of liver function, loss of appetite and poor nutritional status, nutritional support should be given. When patients can eat, they should be instructed to choose some digestible foods with high calorie, moderate protein, high vitamins, low fat and sodium. Take eating less and eating more as the basic principle, avoid cold and hard food, measure the patient's weight regularly and understand the nutritional status. 3. Cleaning care: As drainage tube, indwelling catheter, malnutrition and excessive phlegm may all become potential risks of infection, skin care should be strengthened, and the whole body should be scrubbed with warm water several times a day to keep the El cavity and perineum clean, keep the bed clean and dry, and change sheets and hospital clothes once a day. Strengthen oral care during fasting. Patients and their families should not open the gauze at will and touch the incision with their hands to prevent pollution. When replacing each drainage tube, it is necessary to disinfect it with a cotton swab diluted with iodine tincture, use antibiotics reasonably, prevent and control the occurrence of infection, and closely observe the signs within 5 days after operation: whether there is bleeding point, cyanosis and jaundice, observe the exudation and exudation of injured El, and monitor the patient's urine sugar, urine specific gravity and urine volume. Reasonable arrangement of infusion sequence provides a reliable basis for the diagnosis and treatment of patients. 4. Rehabilitation nursing: Patients undergoing hepatectomy should closely observe their state of consciousness, whether they have mental disorders, decreased self-care ability, abnormal personality and behavior, prohibit high-protein diet, give carbohydrate-based food, and ensure the nutritional balance of water and electrolyte. Bed rest, avoiding strenuous exercise, cleaning the intestine before operation can reduce the source of blood ammonia, eliminate some factors that may cause hepatic encephalopathy after operation, and give oxygen intermittently for 3-4 days after operation to protect liver cells. Keep the oxygen saturation above 95%. 3. Psychological care: Patients with advanced liver cancer will have anxiety, irritability and even suicidal thoughts because of psychological pain. In nursing, they must make psychological and emotional efforts to make patients build up confidence in fighting cancer as much as possible. Patients should have confidence in overcoming diseases. Maintain a stable and happy mood, cooperate with various treatments and nursing with a positive and optimistic attitude, and recover as soon as possible. ?
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