Due to bone marrow and immunosuppression, infection is one of the common complications during chemotherapy. If you find signs of infection, you should immediately check blood, urine, sputum and body fluids and conduct bacterial culture, use broad-spectrum antibiotics quickly, and adjust the use at any time according to the culture results. When leukopenia is obvious, preventive measures should be taken for skin, mouth, gastrointestinal tract and perineum. Pay attention to food disinfection and take antibiotics that are not absorbed by the intestine. Supplement blood components, input new blood when necessary, and take some traditional Chinese medicines to enhance the body's immunity and maintain the function of adrenal cortex.
2. Bleeding
Because of the influence of anti-tumor drugs on platelets and other coagulation factors, patients may have a tendency to bleed. Sometimes platelet transfusion can effectively control active bleeding. Prednisone may be effective for thrombocytopenia. Stop using any drugs that induce bleeding in time, and at the same time, all kinds of hemostasis measures must be taken, including transfusion of whole blood or concentrated red blood cells, plasma dilator and so on to maintain life.
3. thrombosis
According to the literature, the blood of tumor patients is hypercoagulable, accompanied by disseminated intravascular coagulation (DIe), showing various coagulation abnormalities. Therefore, it is necessary to closely observe and find out in time, and at the same time ask patients to pay attention to rest and raise their lower limbs. Once thrombosis is found, heparin, antiplatelet and thrombolytic drugs, such as dipyridamole, urokinase, salvia miltiorrhiza, etc., should be used in time, and thrombi should be removed in severe cases.
4. Punching and blocking
Tumors located in or invading hollow organs, such as small intestinal malignant lymphoma, may appear perforation and bleeding during chemotherapy. Nurses should pay attention to observe and find signs of perforation bleeding and deal with them in time, and the preventive measure is to slow down the administration appropriately. Especially 1-2 times of combined chemotherapy should be paid more attention to. At the same time, we should take active symptomatic treatment.
5. Clever nursing of oral ulcer
Oral ulcer is one of the most common complications of chemotherapy patients. Because chemotherapy drugs will seriously inhibit the hematopoietic system and immune system, make the body's resistance decline, and the oral self-cleaning effect will be weakened. In addition, oral mucosa will be damaged after chemotherapy, and oral ulcers and infections are prone to occur.
Patients with oral ulcer feel pain and can't eat anything. It is forbidden to brush their teeth with a toothbrush. They can rinse their mouths with salt water or 1% hydrogen peroxide, and apply smecta (an antidiarrheal drug sold in pharmacies) locally to promote inflammation healing. If you have a fungal infection in your mouth, rinse your mouth with 3% soda water and apply nystatin.
During chemotherapy, 30 grams of Artemisia capillaris and 250 ml of boiling water can also be used to make patients gargle or drink tea, which has a preventive effect and can also accelerate the healing of mild ulcers.
6, constipation care should pay attention.
Constipation is one of the common complications of cancer patients, and its incidence rate is about 15%. Constipation can cause abdominal pain, abdominal distension, loss of appetite and even irritability, which is often ignored in clinic, thus increasing the pain of patients and affecting the smooth progress of chemotherapy.
First of all, through chemotherapy and health education, let patients realize the adverse effects of constipation on the body and the importance of keeping defecation unobstructed, and consciously develop the habit of regular defecation.
Eating a digestible diet, eating less and eating more meals, diversifying foods, properly supplementing foods containing cellulose such as fruits, vegetables, coarse grains and beans, and ingesting foods such as honey, sesame seeds and walnuts can stimulate intestinal peristalsis and promote defecation;
Drinking water should be sufficient, preferably around 2000ml~3000ml/ day. On the one hand, it can increase urine output, promote the discharge of chemotherapy toxins and reduce the toxic and side effects of chemotherapy, on the other hand, it can fully soften stool and make it easy to discharge;
Drinking warm water on an empty stomach in the morning can stimulate the gastrocolon reflex and promote defecation.
Patients should take proper physical exercise, especially aerobic exercise, such as walking and playing Tai Ji Chuan. Bedridden patients can have abdominal massage, massage on their own initiative, or be operated by family members or nursing staff: put one hand directly above the navel and massage along the colon from right to left with thumb and four fingers to promote intestinal peristalsis and defecation.
7, psychological care, a link that cannot be ignored.
The quality of life of chemotherapy patients is declining. Pain, digestive symptoms, hair loss and so on are bothering them, making them feel lost, psychologically hindered and afraid of death. Coupled with the lingering shadow of cancer recurrence, patients often have obvious psychological obstacles. Psychological unhealthy will inhibit the immune system, and the decline of immune function will re-induce patients' fear of cancer, which will make patients fall into excessive mental stress and make the disease take advantage of it again.
Therefore, we should not only care about patients' physical discomfort, but also let them establish a healthy psychology.
Experts from Hefei Phoenix Cancer Hospital said: First of all, patients should have a strong will, that is, they should have the belief that they can continue to live. Because only by establishing such a belief can we mobilize subjective initiative and enhance the body's disease resistance. Secondly, some psychological relaxation methods can be adopted, such as meditation, to relieve psychological tension and relax the body. Thirdly, targeted drugs can be used under the guidance of a doctor. In addition, proper arrangement of recreational activities is also helpful to patients' mental health.
8, a correct view of Chinese medicine.
In order to reduce adverse drug reactions and avoid recurrence, the most common misunderstanding that chemotherapy patients walk into during the recovery period is to see a doctor and take medicine indiscriminately. A very common phenomenon is that Chinese medicine is eaten more than rice, and some patients take it for four or five years or even more than ten years. Indeed, traditional Chinese medicine can play the role of strengthening the body resistance and consolidating the foundation, but it also has an impact on gastrointestinal function. Long-term use will lead to indigestion and even nutritional deficiency. At present, it is advocated that cancer patients can take traditional Chinese medicine for about half a year during the recovery period.
9. Review regularly
Review is an important measure in the process of cancer treatment, especially for patients after chemotherapy. Many patients think that it is dangerous to get well after chemotherapy, so they ignore the reexamination. Generally, cancer patients should be examined every 3 months within 2 years after completion of treatment, then every 6 months, and once a year after 5 years.
At present, the reexamination items generally include: whether there is lymphadenopathy in the whole body, whether there is a lump in the local area, three routine examinations of blood, urine and stool, blood biochemistry, isotope, B-ultrasound and X-ray examination, and CT and MRI if necessary. Lung, liver, brain, bone and adrenal gland are the parts where cancer cells are easy to metastasize, so special attention should be paid to them. Also check the patient's immune status, such as immunoglobulin. At the time of reexamination, it is best for patients to go to the hospital where they have been treated, because there are patients' treatment data, which is conducive to making correct judgments and timely treatment.
Neither after surgery nor after radiotherapy and chemotherapy is the end point of treatment for cancer patients. Because cancer is different from other diseases, it is a disease that is easy to recur. We can't simply think that the disappearance of clinical symptoms means recovery, nor can we think that the body will recover after the disappearance of lesions. Therefore, cancer patients should be vigilant, pay attention to subtle changes in their bodies, adjust their lives correctly, and ensure the thoroughness of treatment.