肠息肉Chapter 15 Intestinal polyps
学习目标
1.了解肠息肉术后需要观察什么
2.肠息肉术后容易发生什么并发症，如何预防
3.掌握饮食指导、药物宣教
4.掌握以下词汇
complication 并发症
precaution 预防措施
perforation 穿孔
porridge 粥
spicy food 辛辣食物
oral anticoagulants 口服抗凝药
coronary heart disease 冠心病
pathological report 病理报告
Wang Fang is a patient in bed #26 who has been found to have colon polyps during in a health check up.She was admitted to the hospital and received routine treatment before undergoing endoscopic polypectomy.The patient has returned to the ward.Her primary nurse Xiao Li is talking with him and giving her instructions on preventing postoperative complications.
Xiao Li: Hello, Wang Fang.Now the procedure is over.How are you feeling?
Wang Fang: Thanks, nurse.I'm fine.Is there anything that I should pay more attention to?
Xiao Li: Within one week after discharge, please observe the appearance, color, and size of stool.Pay special attention to abdominal pain.They are the signs of bleeding or delayed perforation.It is normal to have a small amount of blood in stool.If you have a large amount of blood in stool or huge abdominal pain, get medical treatment in time.
Wang Fang: OK, thank you, nurse.Do I need to take other precautions?
Xiao Li: After operation, you should rest in bed to prevent complications such as bleeding and perforation.Try to avoid squatting and holding breath.Do not sit, stand, and walk for a long time.Avoid eating and drinking within the first 6 hours after operation.If there is no discomfort, you can eat residue-free and semi-liquid diet for 2 to 3 days.Porridge, noodles, and lotus root powder are preferred in the first week after discharge.You can also eat small portions of egg and fish.Vegetables, fruits, and clumps of indigestible food are allowed three days later.Please keep away from cigarette, alcohol, spicy, and irritating food.In addition, you may choose foods that nourish mucosa and stop bleeding, such as pearjuice, lotus rootjuice, balsam pear, black sesame, etc.Patients should keep off oral anticoagulants or anti-platelet drugs such as aspirin for one week after operation.Drugs for hypertension,diabetes, coronary heart disease and other diseases should be taken as usual.
Wang Fang: OK, nurse, thank you very much.
Xiao Li: You're welcome.And you must stay cheerful and avoid getting angry.Irritability and depression may lead to the contraction of the intestinal mucosa and block blood flow.One week after discharge, check the pathological report of polyps.If it is benign, regular follow-up is needed.If it is malignant, please make an appointment with your doctor and discuss the subsequent treatment plan as soon as possible.
Wang Fang: Thank you so much.I will keep your words in mind.
译文
王芳是26床患者，因体检发现肠息肉，入院后予常规对症治疗后行内镜下肠息肉摘除术，小李是她的责任护士，患者术后安全返回病房，小李护士正在做防范术后并发症宣教。
小李：你好，王芳，现在手术已经做完了，感觉怎么样？
王芳：你好，护士！我现在感觉还好，请问我以后要注意些什么？
小李：出院后1周内观察大便的性状、颜色、量及有无腹痛，及时发现有无出血或迟发性穿孔的可能。少量便血为正常表现，若出现大量便血或腹部疼痛应及时就诊。
王芳：好的，谢谢护士，我还有其他方面的注意事项吗？
小李：术后应卧床休息，以避免出血、穿孔等并发症；术后尽量避免下蹲、屏气的动作，也不宜久坐、久立、久行等。术后应禁食24小时，无不适继而进无渣半流质饮食2～3天；出院后1周内以稀饭、面条、藕粉类软食为主，鸡蛋、鱼肉类可少量摄取，蔬菜、水果、团块状难消化食物3天后摄取，禁忌烟酒、辛辣刺激食物。另外，多吃一些可以营养黏膜、通便止血的食物比较好，如梨汁、藕汁、苦瓜、黑芝麻等。有口服抗凝血药物或抗血小板药物如阿司匹林的患者术后应停药1周，除此之外的高血压、糖尿病、冠心病等疾病所服药物应照常服用。
王芳：好的，护士，太感谢了！
小李：不客气，还有你一定要保持心情开朗，勿郁怒动火，心境不宽、烦躁忧郁会使肠黏膜收缩，血行不畅。出院1周后应关注息肉病理报告，如为良性需定期复查，如为恶性应来门诊随访决定下一步治疗方案，切勿耽误病情的治疗。
王芳：非常感谢你，我会牢记你的话。