Acute appendicitis is the most common acute abdomen in surgery. Clinically, it is characterized by metastatic right lower quadrant pain and fixed tenderness points in the right lower quadrant. Surgery is the main treatment. When caring for patients with acute appendicitis, preparations for emergency surgery should be made before surgery, early movement should be encouraged after surgery, and postoperative complications such as internal bleeding and residual abscess in the abdominal cavity should be closely observed.
Postoperative care
1 Depending on the type of anesthesia, choose an appropriate lying position. For example, patients under lumbar spinal anesthesia should lie flat on their backs for 6 to 12 hours to prevent cerebrospinal fluid leakage and headaches. Patients under continuous epidural anesthesia can lie on their back with a low pillow.
2 Observe vital signs, measure blood pressure and pulse once every hour, and measure three times in a row until stable. If the pulse speeds up or the blood pressure drops, bleeding is considered, and the wound should be observed promptly and necessary measures taken.
3 12 hours after simple appendicitis resection, or after gangrenous or perforated appendicitis resection, if a drainage tube is placed, you should change to a semi-recumbent or low-profile semi-recumbent position after the blood pressure stabilizes. To facilitate drainage and prevent inflammatory exudate from flowing into the abdominal cavity.
4 Diet: No fasting on the day of surgery, liquids on the first day after surgery, soft food on the second day, and normal food on the 3rd to 4th day under normal circumstances.
5 It is forbidden to use strong laxatives and irritating soapy water enemas 3 to 5 days after the operation to avoid increasing intestinal peristalsis, which may cause the appendix stump ligature to fall off or the suture wound to split, such as postoperative constipation. Oral laxatives are available.
6 You can get up and move around 24 hours after the operation to promote the recovery of intestinal peristalsis and prevent intestinal adhesions. It can also increase blood circulation and accelerate wound healing.
7 Elderly patients should keep warm after surgery and pat their backs frequently to help cough and prevent accumulation pneumonia.
Postoperative complications and care 1 Incision infection is often caused by contamination during surgery, and gangrene or perforated appendicitis is particularly likely to occur. If the body temperature continues to rise or fall and then rises again 3 to 5 days after the operation, the patient feels pain in the wound, and the skin around the incision is red, swollen and tender, this indicates an incision infection.
2 Intra-abdominal bleeding and appendiceal artery bleeding are all caused by the detachment of the mesoappendiceal ligature. The patient appears pale, accompanied by abdominal pain, abdominal distension, rapid pulse, cold sweats, drop in blood pressure and other shock symptoms, and must lie down immediately. Sedation, oxygen inhalation, intravenous infusion, and blood drawing for blood type identification and cross-matching to prepare for surgery to stop bleeding.
3 Patients with residual abscess in the abdominal cavity showed persistent high fever after surgery, abdominal pain, abdominal distension, tenesmus, and then symptoms of poisoning. Attention should be paid to the semi-recumbent position for drainage to allow secretions or pus to flow into the pelvic cavity to reduce poisoning, and at the same time strengthen antibiotic treatment. If no improvement is seen, drainage surgery is recommended.
4 Fecal fistula: Fecal fistula can occur if the appendix stump ligature falls off or the intestine is accidentally injured during surgery. Fecal fistulas are usually colonic fistulas. When formed, the infection is usually limited to around the cecum. There is no threat of diffuse peritonitis, the body temperature is not very high, and nutritional deficiencies are not serious. Most of them can heal themselves after antibiotic treatment.
Dietary taboos after surgery
Digestive tract and abdominal surgery are closely related to dietary taboos and must be paid attention to.
1. The intake of any food is taboo. After major surgery on the digestive tract and abdomen, the intestines are in a low-function state and fasting is required.
After 2-3 days after the operation, if the anus is exhausted, it indicates that the intestinal function has begun to recover. At this time, a small amount of liquid diet can be given. After 5-6 days, you can switch to a semi-liquid diet with less residue. During this period, the liquid should be light and nutritious, and should be taken warm to avoid bringing coarse food residue into the liquid. When changing to a low-residue semi-liquid diet, avoid eating soups with chicken, ham and various vegetables. Even if these foods have been cooked thoroughly, you have to wait
It can only be given as appropriate 10 days after surgery.
2. Avoid greasy food Even on the 10th day after surgery, when the body can tolerate soft meals, you should not eat greasy food too early.
3. Two weeks after the surgery, hair removal is prohibited. Although the recovery is good and the sutures have been removed, the body's resistance is still very weak during this period.
The risk of inflammation still exists, so hair growth must be contraindicated. .
Digestive tract and abdominal surgeries include surgeries on the esophagus, stomach, intestines, liver, and gallbladder. However, some minor surgeries, such as appendicitis surgeries, only require fasting for one day after the surgery
Liquid food can be given on the second day, semi-liquid food can be given on the third day, and soft rice can be given on the fifth day; for anorectal surgery, the patient must be fasted for 2-3 days, and then given clear liquid and less residue. Semi-liquid. Limit foods containing crude fiber in the diet, such as celery, Chinese cabbage, coriander, garlic, leeks, Chinese toon, winter bamboo shoots, hairy bamboo shoots, pineapple, etc., to reduce the frequency of bowel movements and undigested crude fiber. Friction of wounds; oral and throat surgery, fasting within 6 hours after surgery, hot liquids within 1-2 days, cold liquids should be the mainstay