In my country, gallbladder stones are one of the high incidences. According to statistics, 1/10 of adults suffer from gallbladder stones. In recent years, laparoscopic cholecystectomy has been widely used. This type of operation has fewer complications and is effective. It is currently the most suitable surgical method for the treatment of gallbladder stones. After the gallbladder is surgically removed, after a period of adjustment and recovery, the patient can obtain its own adjustment compensation, that is, through the compensatory expansion of the bile duct to maintain the basic physiological functions of the body. Then, understanding the preparations before the operation of gallbladder stones and the precautions after the operation is very conducive to the progress of the operation and the recovery of the condition.
Diet preparation: A low-fat diet should be taken before surgery to avoid causing an acute attack of cholecystitis and affecting the surgery. Fasting for dinner the day before the operation, and indwelling a gastric tube in accordance with the doctor’s instructions on the morning of the operation to drain the gastric juice.
Respiratory tract preparation: During laparoscopic surgery, carbon dioxide needs to be injected into the abdominal cavity to produce pneumoperitoneum, which provides a clear vision and saves operating space for the operation. If carbon dioxide diffuses into the blood, it will cause hypercapnia and respiratory depression. Therefore, patients need to exercise their respiratory function before surgery, prevent colds, and quit smoking to reduce the production of respiratory secretions.
Skin preparation: Generally, laparoscopic surgery chooses the approach near the umbilicus, so the patient needs to wash the umbilicus with soapy water, and it can also be cleaned with turpentine or liquid paraffin. Patients with more severe jaundice often have itchy skin. At this time, it is necessary to avoid scratching to damage the skin and then infection. At the same time, because jaundice patients have difficulty in absorbing vitamin K and are prone to coagulation dysfunction, vitamin K injections must be performed before surgery.
Vital signs care: For patients in the acute phase, medical staff will give intravenous fluids to correct their electrolyte disorder; if the patient has toxic shock, blood volume needs to be supplemented, and surgery will be performed after the condition improves; Those with high fever will receive routine high fever care. In addition, medical staff will also check the patient’s various physical functions, including liver function, electrocardiogram, prothrombin time, ultrasound, and cholecystography. Patients with severe liver damage should also undergo liver protection treatment. .
After the gallbladder stone surgery, the nursing content is also very much. Surgery is usually performed under general anesthesia. Therefore, when returning to the ward after surgery, the patient should first adopt a supine position, with his head tilted to one side, and then use the semi-recumbent position after 6 hours. After 24 hours, the patient can be in the medical staff or Carry out early getting out of bed with the help of family members; if the patient has a drainage tube in the abdominal cavity, it must be properly fixed, and the color, appearance and amount of the drainage fluid must be observed; if the patient feels pain, non-medicinal can be used first The pain relief methods, such as distraction, mental comfort, etc., are really unbearable. Analgesics can be used according to the doctor’s advice. After exhausting, you can drink a small amount of water. If there is no discomfort, you can eat some liquid food, such as rice soup or lotus root powder. For one week after the operation, you should maintain a light diet, such as eating soft foods such as noodles, pimple soup, steamed buns, porridge, etc., adhere to the principle of eating small and frequent meals. Within 3 to 6 months after surgery, you should also maintain a light diet and take ” “Steaming, boiling, stewing” cooking method, eat more fruits and vegetables, stay away from high-fat, high-cholesterol, spicy foods, do not overeating, do not touch tobacco and alcohol, still eat small meals; if the patient has dry mouth after surgery In case of circumstance, family members can moisten their lips by dipping a spoon in water; if the patient has difficulty urinating, they can urinate through the induction method, and if necessary, the catheter can be indwelled.
In addition, it is also necessary to prevent postoperative complications. During the operation, 4 incisions of about 1 cm in size are generally made in the patient’s abdomen, which will be covered and protected by Bondi tape after the operation. When the patient coughs, sneezes, or changes positions, the patient should avoid a sharp increase in abdominal pressure and cause the wound to dehisce; In order to avoid venous thrombosis in the lower extremities after surgery, on the first day after surgery, family members can massage the patient’s lower extremities to promote the patient’s venous return and encourage the patient to get out of bed early for activities; pay attention to the skin and sclera. Early detection of the occurrence of jaundice; if yellow-green bile-like drainage appears at the incision site and exceeds 50 ml per hour, it is necessary to suspect the possibility of biliary fistula and report to the doctor in time.