Nursing measures for colon cancer ostomy

Colostomy is a common procedure in colorectal surgery, mainly used for Miles surgery for rectal cancer and treatment of patients with advanced distal obstruction of colon cancer that is difficult to be removed surgically. Various complications often occur after surgery, such as bleeding and necrosis at the colostomy site in the early postoperative period, colostomy intestinal prolapse, colostomy hernia, colostomy stenosis, colostomy intestinal retraction, and colostomy skin and mucosal separation in the mid- to long-term postoperative period. The main reasons are improper surgical operation and unscientific nursing methods.

To prevent these complications, preoperative and postoperative care is required:

1. Before the operation, the doctor should carefully design the position and size of the stoma and make it as compatible with physiological requirements as possible. The colostomy should be 3 cm above the skin surface to facilitate wearing a fecal bag to collect and store feces. It is not appropriate to be too high or too low.

2. Irregular bowel movements are a common complication in the early stages after colostomy surgery, and patients have no awareness of controlling their bowel movements.

The rehabilitation method is to train patients to strengthen their awareness of regular bowel movements through colostomy enema, starting with once in the morning and afternoon each day, and then gradually reducing it, or even completely eliminating it. Each time, 500 ml to 1000 ml of warm water is poured into the colostomy site to stimulate colon defecation; the flow of water depends on the patient's feeling, and the catheter is pulled out after 5-10 minutes of inflow. First, part of the water and feces will flow out with the removal of the catheter, and after 20 minutes, all the remaining water will flow out with the feces. After repeated training, generally three to six months after surgery, almost all colostomy patients can naturally excrete feces regularly.

3. In terms of diet, you should pay attention to eating less foods that are not easy to digest: such as peanuts, melon seeds, pine nuts, walnuts, apricots and other dried fruits; foods high in fiber: such as corn, sorghum, sweet potatoes and some vegetables and fruits high in fiber; foods with seeds: such as strawberries, tomatoes, kiwis, etc. and raw and cold vegetables and fruits; in addition, you should also pay attention to eating less foods with special flavors: such as garlic, onions, leeks, radishes, etc., as well as fish, eggs, milk, mutton, etc. that are easy to produce odors. If the patient does not participate in social activities, the latter can be eaten at will.

4. Patients should pay attention to protecting the skin around the stoma, wash it with warm water and soap every day to keep it clean. If there is corrosion, apply zinc oxide ointment; pay attention to food hygiene and prevent diarrhea. If you need to go out, you can take antidiarrheal drugs to inhibit intestinal peristalsis; avoid actions that increase intra-abdominal pressure. If you have difficulty defecating, wear a finger cot and apply ointment to expand the stoma; if intestinal mucosal prolapse or retraction occurs, you need to go to the hospital emergency department for treatment.