I. Pathology
(1) General morphological classification (Figure 2-87)
1 .colorectal cancer 2. Invasive colon cancer 3. Ulcerative colon cancer
Figure 2-87 Large-scale classification of colon tumors
1. The tumor of mass type (cauliflower type, soft cancer) grows into the intestinal cavity, with large tumor body, hemispherical or spherical protrusion, which is easy to ulcerate and bleed, and secondary infection and necrosis. Most of this type has high differentiation, low invasiveness and slow growth, and is prone to occur in the right colon.
2. Infiltrative tumor (constrictive type, hard cancer) infiltrates around the intestinal wall, with obvious fibrous tissue reaction, grows along the submucosa, and is hard in texture, which is easy to cause intestinal stenosis and obstruction. These cells have low differentiation, high malignancy and early metastasis. It is easy to develop the large intestine far from the right colon.
3. Ulcerative tumor grows deep into the intestinal wall and invades the outside of the intestinal wall. In the early stage, ulcers may appear, with bulging edges and deep bottoms, which are easy to bleed and infect, and easily penetrate the intestinal wall. The degree of cell differentiation is low and the metastasis is early. It is the most common type of colon cancer, mainly occurring in the left colon and rectum.
(2) Organization classification
1. adenocarcinoma Most colon cancers are adenocarcinoma, accounting for about three quarters. Adenocarcinoma cells can be identified and arranged in tubular or acinar shape. According to its differentiation degree, it can be divided into three grades, and the third grade differentiation is the worst, and the cells are arranged in sheets or strips.
2. Mucous cancer cancer cells secrete mucus, and the nucleus can be squeezed to one side in the cell (ring-shaped, called signet ring cell carcinoma). There is mucus and fibrous tissue reaction in the extracellular matrix, and the cancer cells are like islands in flaky mucus. The differentiation is low, which is worse than adenocarcinoma after giving it.
3. Undifferentiated cancer cells are small in size, irregular in shape and arrangement, easy to invade small blood vessels and lymphatic vessels, and have obvious infiltration. Differentiation is very low, and the last one is the worst.
(3) Clinical staging
Dukes A: The cancer is confined in the intestinal wall.
A0 stage: Cancer is confined to mucosa.
A 1 stage: the cancer is confined to submucosa.
Stage A2: Cancer invades the muscle layer of the intestinal wall and does not penetrate the serosa.
Stage Ⅱ (Dukes B stage): Cancer cells infiltrated outside the intestinal wall.
Stage Ⅲ (Dukes C): with lymph node metastasis.
C 1 phase: nearby lymphatic metastasis (paraintestinal)
C2 stage: distant lymphatic metastasis (mesentery)
Stage Ⅳ (Dukes D): Distal metastasis has occurred.
(4) Diffusion and transfer
1. The spread of colorectal cancer is generally characterized by annular infiltration along the transverse axis of the intestine, developing to the deep layer of the intestinal wall, and slowly spreading up and down the longitudinal axis, and the intestinal segment involved is generally less than 10 cm. After cancer invades serosa, it often adheres to surrounding tissues, adjacent organs and peritoneum.
2. Lymphatic metastasis of colon cancer generally spreads from near to far in the following order, but there are also disorderly spanning metastasis.
(1) The colonic lymph nodes are located on the fat side of the intestinal wall.
(2) Paracolonic lymph nodes are located in the mesentery adjacent to the colon wall.
(3) Mesangial vascular lymph nodes are located beside the blood vessels in the middle of the mesocolon, also called intermediate lymph nodes.
(4) Mesangial root lymph nodes are located at the mesenteric root.
After cancer invades the muscle layer of intestinal wall, the possibility of lymphatic metastasis increases. If the subserous lymphatic vessels are invaded, the probability of lymphatic metastasis is greater.
3. Hematogenous metastasis generally means that cancer cells or tumor thrombus first reach the liver along the portal vein system, and then reach other tissues and organs such as lung, brain and bone. Hematogenous metastasis is usually caused by cancer invading capillaries and venules, but it can also be caused by pressing the tumor during physical examination, squeezing the tumor during operation, and even strong peristalsis during obstruction.
4. Invasive cancer can directly invade surrounding tissues and organs. Cancer cells shed in the intestinal cavity, which can be planted on mucous membranes elsewhere, shed in the abdominal cavity, or planted on the peritoneum. Metastasis is nodular or millet-shaped, white or grayish white and hard. Spreading to the whole abdominal cavity can cause cancerous peritonitis and ascites.
Second, the clinical manifestations
(1) Early symptoms
Abdominal distension, discomfort and indigestion may occur at the earliest stage, and then there will be changes in defecation habits, such as increased defecation times, diarrhea or constipation, abdominal pain before defecation, etc. There will be mucus stool or mucus purulent bloody stool in the future.
(2) Poisoning symptoms Due to tumor ulceration, blood loss and toxin absorption, patients often have anemia, low fever, fatigue, emaciation and edema, especially anemia and emaciation.
(3) Intestinal obstruction is characterized by incomplete or complete low intestinal obstruction, such as abdominal distension, abdominal pain (abdominal distension or colic), constipation or constipation. Physical examination showed abdominal bulge, intestinal type, local tenderness, and strong bowel sounds could be heard.
(4) Abdominal mass is a tumor or mass that infiltrates and adheres to the greater omentum and surrounding tissues. They are hard and irregular in shape, and some of them can move with the intestine to some extent. There are many infiltrations in advanced tumors, and the masses can be fixed.
(5) In the late stage, there are signs of liver metastasis such as jaundice, ascites and edema, as well as manifestations of distant spread and metastasis of tumors such as cachexia, anterior rectal recess tumor and supraclavicular lymph node enlargement.
Due to the differences in physiology, anatomy and pathology, the clinical characteristics of left and right colon cancer are also different.
The right colon cancer has a wide intestinal cavity, sparse feces, rich blood supply and lymph in the colon, and strong absorption ability. Most cancers are soft cancers, which are prone to ulceration and necrosis, leading to bleeding and infection, so the clinical manifestations are mainly toxic symptoms. However, intestinal obstruction will also occur when the condition gets worse.
The intestinal cavity of left colon cancer is relatively small, the feces have been viscous, and most of them are invasive cancers, and the intestinal cavity is often annular narrow, so the symptoms of intestinal obstruction appear earlier in clinic, and some even appear acute obstruction. Poisoning symptoms are mild and appear later.
Third, diagnosis
The early symptoms of colon cancer are often ignored by patients, and they are often treated with dysentery, enteritis and other diseases when they arrive at the hospital. Once the symptoms of poisoning or obstruction appear and the abdominal mass is touched, it is not early. Therefore, if the patient has anemia, emaciation, positive fecal occult blood and the above early symptoms, further examination is needed.
(1) X-ray examination includes barium meal examination of the whole digestive tract and barium enema examination. It is suitable for patients with colorectal cancer. The initial pathological signs may be intestinal wall stiffness and mucosal destruction, followed by continuous filling defect and intestinal stenosis. For the discovery of small lesions, double contrast examination of barium and air can be performed by injecting air into intestinal cavity, and the effect is better.
For patients with symptoms of colon obstruction, it is not appropriate to do barium meal examination of the whole digestive tract, because barium is difficult to be discharged after colon dryness, which can aggravate obstruction.
(2) Colonoscopy
The sigmoidoscopy is straight, the longest is 30 cm, which is convenient for examination and can be biopsied under direct vision. It is suitable for diseases below sigmoid colon.
Fiberoptic colonoscopy length 120 ~ 180 cm. It can bend, observe the whole colon, perform electrocision, electrocoagulation and biopsy, and find early lesions. When the above examination is difficult to diagnose, this examination can be done.
(3) Neither B-ultrasound nor CT scan can directly diagnose colon cancer, but it is valuable for the location and size of the tumor, the relationship with surrounding tissues, and the determination of lymph node and liver metastasis.
(4) Serum carcinoembryonic antigen (CEA) is not specific for colon cancer, and its positive rate is uncertain. The high value is often related to tumor enlargement. After complete resection of colon tumor, it can return to normal value and increase several weeks before recurrence, which is of great significance for judging prognosis.
Fourth, differential diagnosis.
(1) Benign tumor of colon has a long course and mild symptoms. X-ray shows local filling defect, regular shape, smooth surface, sharp edge, no stenosis of intestinal cavity and complete colon bag.
(2) Colitis diseases (including tuberculosis, schistosomiasis granuloma, ulcerative colitis, dysentery, etc. ) has its own characteristics in the history of intestinal inflammatory diseases. Microscopic examination of stool may have its special findings, such as eggs and phagocytes. Dysentery can cultivate pathogenic bacteria. X-ray examination showed that the affected intestine was long, but the cancer rarely exceeded 10 cm. Colonoscopy and histopathological examination are also different, and further diagnosis can be made.
(3) Other colonic spasm: X-ray examination showed that the small intestine stenosis was reversible. Appendiceal abscess; There was an abdominal mass, but X-ray examination showed that the mass was outside the cecum, and the patient had a history of appendicitis.
Verb (abbreviation of verb) processing
At present, surgical resection is still the main treatment method, which can be supplemented by chemotherapy, immunotherapy and traditional Chinese medicine.
(1) surgical treatment
1. Preoperative preparation In addition to routine preoperative preparation, intestinal preparation must be made for colon surgery, including ① bowel cleansing: eating a small amount or no residue two days before operation; Take laxatives 1 ~ 2 days before operation, and take them a few days in advance if you have constipation or incomplete intestinal obstruction; According to the difficulty of defecation, clean enema can be carried out one or several days before operation. ② Intestinal disinfection: kill pathogenic bacteria in the intestine, especially common anaerobic bacteria such as Bacteroides fragilis and gram-negative aerobic bacteria. The former is mainly metronidazole, and the latter can be sulfonamides, neomycin, erythromycin, kanamycin, etc. Adequate intestinal preparation can reduce intraoperative pollution and infection, which is conducive to healing.
At present, some hospitals at home and abroad adopt the method of total intestinal lavage for intestinal preparation. The method is to drip or orally take a special irrigation solution (containing a certain concentration of electrolyte and intestinal disinfectant to maintain a certain osmotic pressure), the dosage is 4 ~ 8 liters, and squat on the defecation device. Can achieve the purpose of cleaning intestinal tract and disinfection at the same time.
2. Surgical methods
(1) right hemicolectomy (fig. 2-88) is suitable for blind colon cancer, ascending colon cancer and hepatic carcinoma of colon. Excision range: ileum terminal 15 ~ 20 cm, right half of cecum, ascending colon, transverse colon, mesentery and lymph nodes. Most of the lymph nodes in the transverse colon and the right gastroepiploic artery group still need to be removed for liver cancer. After resection, the colon is anastomosed end-to-end or end-to-side (colon closure).
Right hemicolectomy with preservation of middle colonic artery
Figure 2-88 Right Hemicolon Cancer Resection
(2) Left hemicolectomy (Figure 2-89) is suitable for carcinoma of descending colon and splenic flexure of colon. Scope of resection: left hemitransverse colon, descending colon, part or all of sigmoid colon and its mesentery and lymph nodes. End-to-end anastomosis after resection of colon or colon and rectum.
Figure 2-89 Left colon cancer resection
(3) Transverse colectomy (Figure 2-90) is suitable for transverse colon cancer. Scope of resection: transverse colon and its hepatic curvature and splenic curvature. After resection, end-to-end anastomosis of ascending and descending colon was performed. If the anastomotic tension is too high, right hemicolectomy can be added for ileocolic anastomosis.
Figure 2-90 Excision of transverse colon cancer
(4) Radical resection of sigmoid colon cancer (Figure 2-9 1) According to the specific part of the cancer, besides resection of sigmoid colon, resection of descending colon or partial resection of rectum is also performed. Colon-colon or colorectal anastomosis.
Fig. 2-9 1 sigmoid colon cancer resection
(5) Surgical principles for patients with intestinal obstruction If the intestinal contents are significantly reduced after preoperative preparation, one-stage resection and anastomosis can be performed if the patient's conditions permit, but protective measures should be taken during the operation to minimize pollution. If the intestine is full and the patient's condition is poor, colostomy near the tumor can be performed first, and then the second-stage radical resection can be performed after the patient's condition improves.
(6) Surgical principles: Radical surgery cannot be performed when the tumor is widely invaded locally, or it cannot be removed after being fixed with surrounding tissues and organs. If the intestine has been obstructed or may be about to be obstructed, short-circuit surgery between the distal and proximal ends of the tumor can be used, and colostomy can also be performed. If there is distant organ metastasis, local tumor is still allowed to be removed, and local palliative resection can be used to alleviate symptoms such as obstruction, chronic blood loss, infection and poisoning.
3. Matters needing attention in operation
(1) After laparotomy, the exploration of the tumor should be light and should not be squeezed.
(2) During resection, the blood vessels at the root of tumor mesangium should be blocked first to prevent the blood from being transferred. And separated from the mesenteric root to the intestine.
(3) Blocking the intestine with a cloth belt at the position where the intestine is to be cut, so as to reduce the implantation and metastasis of cancer cells in the intestine. Some people advocate injecting anticancer drugs into the blocked intestine, usually 5- fluorouracil 30 mg/kg body weight, diluting with 50 ml normal saline, and separating the intestine after 30 minutes.
(4) When it adheres to the surrounding tissues, it can be removed as much as possible.
(5) Before abdominal closure, the abdominal cavity should be fully flushed to reduce cancer cell implantation and abdominal infection.
(2) drug therapy
1. Chemotherapy can generally be used for patients with 2 ~ 3 courses of chemotherapy within one year to one and a half years after operation. The commonly used drug is mainly 5- fluorouracil (5-FU), and mitomycin and cyclophosphamide can also be used in combination. The total amount of 5-FU can be 7 ~ 10g per course of treatment. It can be administered orally or intravenously, and it is best to add it into glucose solution and drip it, 250 mg each time, once a day or every other day. If the reaction is serious, such as nausea, loss of appetite, fatigue, and decreased white blood cell and platelet counts, the dosage can be reduced or the interval time can be increased. When the bone marrow suppression is obvious, the drug can be stopped in time. The gastrointestinal reaction of oral administration is greater than that of intravenous administration, but the bone marrow inhibition reaction is lighter.
We must pay attention to supporting treatment and medication to reduce the side effects during medication.
For patients with unresectable cancer, chemotherapy can relieve symptoms and control tumor growth to a certain extent, but the effect is poor and the maintenance time is short. For example, when the patient's general condition is poor, the side effects are obvious, but the condition is aggravated and it is not suitable for application.
2. Immunotherapy can improve the anti-tumor ability of patients, which has developed rapidly in recent years, such as interferon, interleukin, transfer factor, tumor necrosis factor and so on. , and has gradually been widely used, which can not only improve the immune ability of patients, but also cooperate with chemotherapy.
3. Chinese medicine treatment can improve symptoms, enhance the body's disease resistance and reduce the side effects of radiotherapy and chemotherapy. Some traditional Chinese medicines have direct anticancer effects, such as Hedyotis diffusa, Scutellaria barbata, Shā rotto Katakuri and Solanum nigrum. When taking medicine, we can give consideration to syndrome differentiation and disease differentiation, and add drugs such as clearing away heat and toxic materials, promoting blood circulation and removing blood stasis, nourishing yin and blood, resolving phlegm and resolving hard mass, and regulating spleen and stomach.
Prognosis of intransitive verbs
Colon cancer is better after treatment, and the overall five-year survival rate after radical operation can reach more than 50%. If the patient is in the early stage, the five-year survival rate can reach more than 80%, while the late stage is only about 30%.
References:
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After colon cancer surgery, you should go to the hospital regularly for check-up and rehabilitation measures. The specific survival time after treatment is related to your physique, rehabilitation environment and postoperative radiotherapy and chemotherapy.
At present, the cause of colon cancer has not been really understood, and doctors have different views on whether colon cancer can be inherited.
A family was investigated abroad. In 75 years, * * * has more than 650 blood relatives, 96 of whom are patients with malignant tumors, most of which are colon cancer, accompanied by adenocarcinoma of other organs. It has been found that the risk of colon cancer among compatriots is five times higher than that of the general population; Family factors of colon cancer are more common than other digestive tract cancers. So many doctors believe that genetic factors are related to colon cancer.
References:
/JBZT/NK- 1/XHK- 1/WCGN- 1/20050202 1749244084 . htm
Traditional Chinese medicine diet therapy
(1) water chestnut porridge: 20 water chestnuts with shells, honey 1 spoon, and appropriate amount of glutinous rice. (1) Wash and mash water chestnuts, put them into a crock and add water to cook them into a semi-paste. ② Add appropriate amount of glutinous rice to cook porridge, and add honey to taste when porridge is cooked. Take it regularly, which is beneficial to the function of moistening the stomach and intestines.
(2) Lotus root juice, plums and eggs: 8 grams of plums, eggs 1 egg, and appropriate amount of lotus root juice. Mix the dark plum kernel and lotus root juice, put them into eggs, seal them with wet paper and steam them. Twice a day, each time 1 dose, has the functions of promoting blood circulation, stopping bleeding, cooling blood and hematochezia.
(3) Qumaigen decoction: fresh Qumaigen 60g or dry root 30g. Wash it with rice swill first, and add water to fry it into soup. Daily 1 dose has the effect of clearing away heat and promoting diuresis.
(4) Poria cocos eggshell powder: Poria cocos 30g, eggshell 9g. Melt Poria and egg shell, and grind into powder. Twice a day, each time 1 dose, with boiled water. This medicated diet has the effects of nourishing vegetables and regulating qi in the liver, and can be used for patients with obvious abdominal pain and abdominal distension. In addition, Frye porridge can also be used.
(5) Mulberry pork soup: 50 grams of mulberry, jujube 10, and appropriate amount of lean pork. Mulberry is cooked with jujube, pork and salt until cooked. Often taken, it can tonify the middle warmer and replenish qi, and is used for people with small abdominal distension.
(6) Lotus seed soup: 5 fresh lotus seeds. If you don't have fresh lotus seeds, you can use dried lotus seeds instead and add a little rock sugar. Wash lotus seeds first, cut into pieces, add appropriate amount of water, decoct for 1 hour, then take soup and add rock sugar. Three times a day, this meal can be used for those who have the functions of clearing heat and cooling blood, stopping bleeding and hematochezia.
(7) Houttuynia cordata lotus seed soup: Houttuynia cordata 10g, lotus seed meat 30g, decocted with water. Take it twice every morning and evening. It has the functions of clearing away heat, eliminating dampness, purging fire and detoxicating, and is suitable for those who are in urgent need.
(8) Stewed large intestine with papaya: papaya 10g, and large intestine of fat pig 30cm. Put papaya into the cleaned large intestine, tie both ends tightly, and stew until cooked. Eating soup and intestines, this diet has the functions of clearing away heat and regulating stomach, promoting qi circulation and relieving pain.
(9) Leech seaweed powder: leech 15g, seaweed 30g. Dry leech and seaweed are ground into fine powder and divided into 10 packets. 2 packets a day, taken with yellow wine, this meal has the functions of removing blood stasis, clearing away heat and detoxifying.
(10) Lingyiteng decoction: water chestnut 10, coix seed 12g, fresh perilla frutescens 12g. Tear perilla into pieces, and then decoct with water and coix seed. 3 grams a day, clearing away heat and toxic materials, strengthening the spleen and promoting diuresis.
(1 1) cinnamon sesame pot pork intestines: 50 grams of cinnamon, 60 grams of black sesame, and about 30 centimeters of pork intestines. After cleaning the pig's large intestine, put cinnamon and sesame into the large intestine, tie both ends tightly, add water to cook, remove cinnamon and black sesame and season. Eat soup and intestines. This meal can be used for patients with qi deficiency, small abdominal distension and frequent defecation.
(12) Rhubarb and Sophora japonica honey beverage
Raw materials: 4 grams of rhubarb, 30 grams of Sophora japonica, 0/5 grams of honey/kloc-,2 grams of green tea.
Method: First, remove impurities from raw rhubarb, wash it, dry it in the sun or dry it in the sun, cut it into pieces, put it in a casserole, add appropriate amount of water, boil it for 5 minutes, and then remove residues and leave juice for later use. Put Sophora japonica and tea leaves in a pot, add appropriate amount of water, boil, pour in raw rhubarb decoction, leave the fire, cool slightly, and mix well with honey while it is hot.
Usage: Take it twice in the morning and evening.
Efficacy: clearing away heat and toxic materials, cooling blood and stopping bleeding. This dietotherapy prescription is suitable for patients with colorectal cancer with hematochezia, scarlet blood and hematochezia after cancer operation.
(13) purslane Sophora japonica porridge
Raw materials: fresh purslane100g, Sophora japonica 30g, japonica rice100g, and brown sugar 20g.
Methods: First, fresh purslane was picked up, washed, blanched in boiling water pot, fished out, neatly packed and cut into pieces for later use. Sorting Flos Sophorae Immaturus, cleaning, air drying or sun drying, and grinding into fine powder for later use. Wash the japonica rice, put it in a casserole, add some water, and boil it over high fire. When the porridge is ready, add the fine powder of Sophora japonica, the crushed purslane and brown sugar, and then simmer until it boils.
Usage: Take it twice in the morning and evening.
Efficacy: Sophora japonica is cool and bitter, and has the functions of clearing away heat and blood, clearing liver and purging fire to stop bleeding. This dietotherapy prescription is suitable for hematochezia and scarlet caused by patients with colorectal cancer.
Syndrome differentiation treatment of traditional Chinese medicine
Heat-toxic hyperactivity type
clinical picture
Abdominal distension and pain, frequent defecation, pus and mucus in stool, loss of appetite, yellow greasy fur and thready pulse.
Dietotherapy medicated diet
1, hawthorn Tianqi porridge: 20 grams of hawthorn, 5 grams of Tianqi (ground), 60 grams of japonica rice, honey 1 spoon, add appropriate amount of water, and cook porridge twice a day.
2, sea cucumber fungus pig intestine soup: 60 grams of sea cucumber, fungus 15 grams (water hair), pig intestine 1 about 50 cm (washed and cut into small pieces), boiled and seasoned.
3. Xiang Lian stewed pork intestines: Radix Aucklandiae 1 0g, Radix Chuanxiong 6g, pork intestines1segment (washed) 30cm, and Radix Notoginseng 5g. Put Radix Aucklandiae, Rhizoma Coptidis, and Radix Notoginseng together into the fat sausage, tie both ends tightly, stew the intestines with water, and take medicine and soup to eat the fat sausage.
Qi stagnation and blood stasis type
clinical picture
Abdominal distension and pain, hard abdominal mass, dark purple or purulent stool, or acute and heavy interior, dark purple tongue or ecchymosis, thin yellow fur, thin and astringent pulse.
Dietotherapy medicated diet
1. Pig blood crucian carp porridge: pig blood 200g, crucian carp 100g, rice 100g. Scaled crucian carp, removed intestinal impurities and gills, cut into small pieces, and cooked porridge with pig blood and rice. 65438+ 0-2 times a day.
2. Water chestnut, coix seed and notoginseng lean broth: water chestnut 15 tablets, coix seed 20g, notoginseng rice 5g, lean meat 60g (chopped), boiled until cooked, and salted.
Yin deficiency of liver and stomach
clinical picture
Abdominal pain is faint and the lump is palpable. Dry stool is granular or small and flat, with bitter taste and dry mouth, anorexia or vomiting, red tongue and rapid pulse.
Edible medicated diet
1, auricularia auricula+0.5g (water hair), daylily 30g, silky fowl 1 (about 500g) to remove hair and viscera. Stew black-bone chicken for 1 hour first, then add black fungus and water lily leaves until everything is cooked and rotten, and add salt to taste as seasoning.
2. Fairy porridge: 60 grams of raw Polygonum Multiflori Radix, 0/00 grams of japonica rice/kloc, 6 red dates (denuded), and appropriate amount of brown sugar. Decoct Polygonum multiflorum Thunb. Take the thick juice, remove the residue, and put glutinous rice and red dates into a casserole to cook porridge. When the porridge is ready, add brown sugar to taste and cook for a while.
3. Shuangshen Zhuxu Soup: Codonopsis pilosula 30g (finely cut and wrapped with gauze), sea cucumber 200g (soaked), kelp 50g, pig spine 50g (finely cut), appropriate amount of water, boiling with strong fire, simmering for 3h, seasoning with salt, removing Codonopsis pilosula residue, and eating meat with soup.
Dietary principles and requirements of colon cancer
First, diet therapy.
The main physiological function of colon is to absorb water and store food residues to form feces. The glands of colonic mucosa can secrete thick mucus, which is alkaline and can neutralize the fermentation products of feces. When colon cancer occurs, physiological function is destroyed, defecation function and general condition are affected, and symptoms such as diarrhea, defecation difficulty and weight loss appear. If you still don't pay attention to diet, eating some indigestible foods and cancer-promoting foods will aggravate the progress of colon cancer and make the whole body fail. Patients with colon cancer must pay attention to their daily diet.
Studies have proved that high-fat diet can promote the occurrence of intestinal tumors, especially polyunsaturated fatty acids, which can reduce blood lipid but promote cancer. Cholesterol itself does not cause cancer, but at the same time it reacts with cholic acid, which can promote cancer, indicating that cholic acid is a cancer-promoting factor. Therefore, patients with colon cancer should not eat too much fat, the total fat accounts for less than 30% of the total heat energy, and the proportion of animal and vegetable oil should be appropriate. In other words, in a day's meal, including the amount of fat in the food itself, plus cooking oil, the daily fat should be below 50 grams. Some friends are afraid of coronary heart disease and control animal fat very strictly. They often take vegetable oil as the main ingredient, and even don't eat animal oil, which will cause too much peroxide in the body. Because the carbon chain in vegetable oil is unstable and easy to oxidize, if you eat some animal fat properly, it will make the carbon chain stable and not easy to oxidize, and reduce the formation of free radicals in the body. Therefore, we must eat scientifically and pay attention to the reasonable proportion of oil. It is suggested that the ratio of saturated fatty acids to polyunsaturated fatty acids and monounsaturated fatty acids is 1: 1: 1.
Pay attention to eat more vegetables rich in dietary fiber, such as celery, leek, cabbage, radish and other green leafy vegetables. Vegetables rich in dietary fiber can stimulate intestinal peristalsis, increase defecation times, and take away carcinogenic and toxic substances in feces. If colon cancer bulges into the intestinal cavity and the intestinal cavity narrows, it is necessary to control the intake of dietary fiber, because excessive intake of dietary fiber will cause intestinal obstruction. At this time, digestible, soft and semi-liquid foods should be given, such as millet porridge, lotus root powder thick soup, rice soup, porridge, corn porridge, egg soup and tofu. These foods can reduce the irritation to the intestine, pass through the intestinal cavity smoothly and prevent intestinal obstruction.
Patients after colon cancer surgery should follow the doctor's advice to eat and drink like other patients undergoing gastrointestinal surgery. Diet should start from soft, gradually adapt to the body, and then add other diets. Be careful not to eat too much fat, and mix with sugar, fat, protein, minerals, vitamins and other foods reasonably. There should be cereals, lean meat, fish, eggs, milk, various vegetables and bean products every day, and the amount of each should not be too much. Only in this way can we supplement all kinds of nutrients needed in the body. If you can't eat normally in the early postoperative period, intravenous fluid replacement should be given priority to. Pay attention to strengthening nursing and diet nutrition after operation to promote the recovery of patients.
In the early stage of intestinal cancer, stool changes often occur, sometimes constipation, sometimes diarrhea and bloody stool. Some patients have constipation and diarrhea alternately. Therefore, patients with early colorectal cancer should pay attention to adjusting their stools and eat more foods with more crude fiber in their diet, such as potatoes, sweet potatoes, bananas and vegetables. But the processing should be careful to avoid the stimulation of the tumor site by too rough food. Foods rich in cellulose can make the stool have real capacity, which can not only prevent constipation, but also prevent diarrhea to some extent and ensure regular defecation every day.
Patients with advanced colorectal cancer have intestinal stricture due to the growth of malignant tumor invading the intestine, which blocks defecation to varying degrees and reduces food intake. At this time, we should pay attention to giving patients foods rich in nutrition and low in crude fiber, such as eggs, lean meat, bean products, flour and rice, and young leaf vegetables. And told patients to drink more honey water and eat more bananas and pears, among which honey has the best laxative effect.
Patients with intestinal cancer should not eat spicy food. Peppers, peppers and other foods have a stimulating effect on the anus and must not be eaten.
Second, one-day recipes for example (postoperative recovery period)
Breakfast: millet porridge (50 grams of millet), corn flour cake (50 grams of corn flour) and Chinese cabbage (50 grams of Chinese cabbage).
Meal: 1 apple (200g apple).
Lunch: steamed stuffed bun (50g eggs, Chinese cabbage 100g, celery 100g, flour 100g) and soup (50g tomatoes, 50g cucumbers and starch 10g).
Meal addition: make a small bowl of lotus root starch 1 (lotus root starch 30g, sugar 10g) and 2 vegetable biscuits (flour 20g).
Dinner: 50 grams of rice porridge (50 grams of rice), steamed bread (50 grams of flour), mixed tofu (North tofu100g), and steamed garlic mixed with tomato sauce (eggplant100g).
Meal: Sweet milk (fresh milk 250g, sugar 5g) and cake 50g.
10g edible oil, 6g salt.