In fact, it is also a kind of happiness to be able to pull a baby smoothly. Not everyone can have this basic life skill, such as patients with rectal cancer. With rectal cancer, in order to survive, many patients have to choose to remove the original anus and then add an artificial anus.
[Artificial anus], in short, is to make a hole in the stomach (lower left abdomen), pull out a small section of intestines, make an artificial anus, let feces out.
With the artificial anus, although the defecation problem of the patient has been solved, it is far from the defecation habit formed since childhood. At first, the patient may intentionally control defecation because he is not used to it. How to rebuild the defecation habit and how to eat is helpful for smooth defecation need to be done bit by bit. Moreover, the artificial anus needs careful care. From the initial postoperative wound care, anal enlargement to the replacement of anal bags, it is a technical job.
Postoperative wound nursing
1. Before the artificial anus is opened: Vaseline or normal saline gauze is applied externally to the artificial anus opening 2-3 times a day to prevent skin infection and edema around the ostomy (the artificial anus opening); Zinc oxide ointment can also be applied to the skin around the stoma to prevent skin erosion and ulcer.
2. The artificial anus can be opened 2-3 days after operation: after the artificial anus is opened, lie on one side (on the same side as the stoma), which can prevent intestinal fluid and thin feces from flowing out and polluting the abdominal incision and causing infection;
3. Clean the ostomy and the surrounding skin regularly with normal saline, and then cover the ostomy with oil gauze (a kind of medical gauze, which will be provided by the hospital), so that the outflow liquid can be absorbed, and the skin at the ostomy can be kept moist, which is helpful for wound healing;
4. Pay attention to the observation of artificial anostomy for redness, suppuration, erosion and other manifestations of infection; Observe whether there is any color change at the stoma. If it looks ruddy, shiny or dark red, it indicates good blood supply. If it turns pale, black and other colors, the blood supply may not be good. If infection or poor blood supply is found, they should be treated in a timely manner in the hospital.
Postoperative anal enlargement
Artificial anal enlargement should be started one week after the stoma is opened and lasted until 3 months after discharge.
Specific methods: Finger sleeve rubber finger sleeve, coated with lubricant, slowly extend the finger into the artificial anus 4 cm, stay in 1 ~ 2 min, 1 ~ 2 times a day. When inserting the finger, you can open your mouth and breathe, the action must be gentle, the insertion depth must not be too deep, to prevent intestinal perforation.
Replacing the anus bag
After the operation, the nurse will recommend different types of ostomy pockets according to the patient’s condition and ostomy size, and help cut them out.
1. Change during what: When the anal bag is full of one-third of excrement, replace it in time;
2. How to change: When changing bags, the patient should sit up and take the anal bag gently, starting from above, to prevent skin damage. Feces in the bag should be dumped and cleaned in time to avoid infection and peculiar smell.
3. Precautions: The 2 anal bags shall be used alternately in time. The replaced anal bags shall be boiled and disinfected. Observe and record the exhaust situation of the patient. Do not use the anal bags before exhaust.
Establish new defecation habits
In order to establish a new defecation habit as soon as possible, patients can drink a cup of cold boiled water every morning to stimulate defecation, and perform abdominal massage in the morning and evening (palm strokes the abdomen, regular and slightly vigorous friction circles are enough).
Avoid actions that increase abdominal pressure, such as lifting up, lifting heavy objects, coughing violently, etc.
Pay attention to reasonable diet
Fasting for 2-3 days after the operation, after bubbles overflow from the artificial anus, you can start to eat some liquid diet, such as rice soup and vegetable soup; After one week, you can eat semi-liquid diet, such as porridge and noodles. After 2 weeks, you can eat some easily digestible food with less residue and remember to drink more water.
1. Eatable:
In the later period, eat more foods that are conducive to stool formation, such as potatoes and sweet potatoes, so that it is more convenient to clean up stool. Eat more digestible high-protein foods, such as lean meat, fish, chicken, liver, eggs, tofu, etc. Eat more easily digestible vegetables and fruits, such as vegetable juice, vegetable puree, fruit juice, etc.
Cooking is mainly boiled, stewed and steamed, with less frying.
In short, diet should choose soft, rotten, less oil, light, easy to digest, no strong irritation of food.
2. Do not eat:
Raw, cold and stimulating foods, such as pepper, curry powder, chili, mustard and other seasonings;
Crude fiber vegetables, such as celery, leeks, garlic sprouts, etc.;
Strong coffee, alcohol and other beverages;
Foods with special smell, such as garlic, scallion, radish, etc. (mainly, these foods will make the stool also have foul smell, which is not very good …)