How to care for ovarian tumor after surgery

Ovarian tumors are common in women of childbearing age and are a common tumor in the female reproductive organs. This disease is very harmful to women's health. More than 96% of ovarian tumors are benign tumors. Because the ovaries are located in the pelvic cavity, most tumors are asymptomatic in the early stages, and there is a lack of early diagnosis and differential diagnosis methods. Therefore, when symptoms of cancer are found, about 2/3 are in the late stage, which brings great difficulties to treatment and becomes the most threatening gynecological tumor. In order to completely eliminate the cause, surgical treatment is required, and the postoperative healing is good without infection and other complications.

1. Preoperative care

1. Psychological care: The ovary is one of the important reproductive organs of women. Patients generally worry about whether the removal of the ovary will affect their body and sexual life, whether the tumor will become malignant, etc. Especially for young patients, different care should be formulated according to different mentalities. Give more care, let the patient know the surgical method and the recovery process after the operation, eliminate fear, pessimism, and disappointment, be kind and friendly, do not discuss the condition in front of the patient at will, encourage them to stay optimistic and actively cooperate with the treatment.

2. General preparation: Check the functions of the patient's heart, lungs, liver, kidneys and other important organs; measure T, P, R, BP twice a day, pay attention to the presence of menstruation, and report any abnormalities to the doctor; local skin preparation: the patient should bathe and change clothes before surgery, and skin preparation should be performed 1 day before surgery. The skin preparation range is from under the xiphoid process, to the mid-axillary line on both sides, and to the pubic mound and the upper 1/3 of the thigh; preparation 1 day before surgery: do a skin test (penicillin, procaine), eat a semi-liquid dinner, fast after midnight, take senna leaf water 200-300 ml orally before going to bed, and give sedatives and sleeping pills at night as prescribed by the doctor to ensure that the patient has a good rest; preparation on the day of surgery: measure vital signs, disinfect the vagina with 0.1 chlorhexidine, insert a urinary catheter, and leave a urinary catheter in place.

2. Postoperative Care

General postoperative care is similar to postoperative care for abdominal surgery. Generally, the patient should be placed in a semi-recumbent position after blood pressure stabilizes on the second day after surgery, which is conducive to the drainage of abdominal and vaginal secretions and reduces inflammation and abdominal distension. Patients undergoing intestinal resection should be temporarily fasted, and continuous gastrointestinal decompression should be performed according to the doctor's instructions to maintain patency, and the drainage volume and nature should be recorded. For those whose intestines are not invaded, a liquid diet can be given on the second day, and gastrointestinal motility drugs can be taken at the same time to promote the recovery of intestinal peristalsis. After 3 days, a semi-liquid diet or ordinary diet should be changed according to the recovery of intestinal peristalsis to maintain smooth bowel movements. During bed rest, skin care should be done to avoid bedsores. Encourage bed activities, tapping the back, clearing sputum in time, and preventing lung complications. When the condition permits, assist the patient to get out of bed.

1. When the patient is sent back to the ward after surgery, the nurse must hand over the shift to the anesthesiologist face to face. Patients with hard external anesthesia should lie flat without a pillow for 6 to 8 hours, and take a semi-recumbent position the next morning after surgery.

2. After the analgesic and anesthetic effects disappear, the patient still feels pain in the wound. According to the doctor's advice, the patient will be given diazepam or pethidine for analgesia. The patient often experiences varying degrees of nausea and vomiting after surgery, and generally no special treatment is given.

3. Observation of the condition After surgery, pay attention to observe whether there is bleeding or exudation in the incision and vaginal stump, and change the dressing and perineal blood pad in time. For patients with incision pain, use analgesics as prescribed by the doctor. For patients undergoing tumor cell reduction surgery, one extraperitoneal drainage tube and one intraperitoneal chemotherapy tube are generally placed after surgery. The end of the indwelling chemotherapy tube is wrapped with sterile gauze and fixed to the abdominal wall to prevent it from falling off, so as to prepare for postoperative intraperitoneal chemotherapy. The drainage tube is connected to the negative pressure drainage bag, fixed well, and the drainage is kept unobstructed. The drainage volume and the properties of the drainage fluid are recorded. After the patient returns to the ward after surgery, BP, P, and R should be measured immediately to understand the changes in blood pressure after moving the patient, because any anesthesia and surgery have an inhibitory effect on the circulatory system, and changes in body position can also affect the circulatory status. Usually, BP and P are measured once every 15 minutes, and after the blood pressure stabilizes, it is changed to once every 30 minutes until it stabilizes. T, P, R, and BP are measured 4 times a day until it returns to normal 3 days later.

4. Keep the urinary catheter unobstructed and observe the urine volume. Keep the urinary catheter for 1 to 2 days after the operation and keep the vulva clean by wiping it with 0.1% chlorhexidine 1 to 2 times a day.

5. Observation and care of the wound: Within 24 hours after the operation, observe the wound dressing for bleeding or exudation. If the dressing is leaked and loses its function of protecting the wound, it should be replaced in time. At the same time, the area around the wound should be kept clean, dry and free of pollution. When changing the dressing, check whether there are any abnormal phenomena such as nodules, redness, swelling, tenderness, etc. at the incision. Remove the stitches and change the dressing on the seventh day.

6. Advise the patient to move early to promote the recovery of systemic functions and blood circulation to reduce postoperative adhesions. Strengthen nutrition and supplement adequate calories and vitamins every day after surgery.

7. Psychological care. Postoperative patients worry that the removal of one or part of the ovary will affect their future menstrual cycle and sexual life, affecting their health and life. Medical staff should patiently explain the basic knowledge about ovarian function to patients, guide them on postoperative sexual life knowledge, and eliminate psychological stress and stimulation factors. During the entire nursing process, nursing staff should focus on patients, listen to their statements, care about their pain, and then provide guidance, comfort, and encouragement. Help eliminate their heavy mental pressure and facilitate postoperative recovery.