Adaptive exercises for post-operative changes

Blood transfusions and fluids

Prevent infection

Calories, protein and vitamins

Gastrointestinal tract preparation

Others: such as sedation, gastric tube and urinary tube, etc.

establish trust

Communicate about the condition, diagnosis and treatment (patient - appropriate explanation, family member - detailed explanation)

Fill out the informed consent form (surgery, anesthesia)

Impairs healing and may lead to infection

Body weight, subcutaneous fat thickness

plasma albumin

Perioperative stroke is rare (generally <1%, cardiac surgery 2%-5%)

Those with a history of stroke need to postpone surgery for at least 2 weeks, preferably 6 weeks

Prophylactic use of low molecular weight heparin

hypertension

disease assessment

Types of heart disease and surgical tolerance

Preoperative preparation for cardiovascular disease

No smoking, deep breathing and cough training

Use of tracheal antispasmodics and corticosteroids

aerosol inhalation

Avoid medications that depress breathing and increase the viscosity of sputum

Control infections and improve lung function

For acute respiratory tract infection, strengthen anti-infective treatment and perform surgery 1-2 weeks after cure

If emergency surgery is required, antibiotics should be administered and inhalation anesthesia should be avoided

For patients with severe pulmonary insufficiency and concurrent infections, active measures must be taken to improve lung function and control the infection before surgery can be performed.

liver

kidney

Surgery should be performed as early as possible on the day to shorten the preoperative fasting time and avoid ketoacidosis. During the operation, insulin can be added to the glucose solution at a ratio of 5:1 Determine the dosage of insulin based on urine glucose measurement results every 4 to 6 hours The urine glucose is , use 12U; give 8U; give 4U; do not use insulin. If urine ketones are positive, the insulin dose should be increased by 4U In case of ketoacidosis, use 250ml of 5% glucose and 12U of insulin continuously intravenously, and Prevent and treat hypokalemia

Detailed medical history: prone to bleeding, history of thrombosis, history of blood transfusion, menstruation, anticoagulant drugs, etc. Antiplatelet drugs (ticlopidine and clopidogrel) were stopped 10 days before surgery. 7 days before surgery, stop aspirin >Stop non-steroidal anti-inflammatory drugs 2 to 3 days before surgery If coagulopathy is clinically determined, appropriate treatment should be carried out before elective surgery. Platelets <50×109/L, platelet transfusion is recommended For major surgery or surgery involving blood vessels, platelets should be maintained at 75×109/L For neurological surgery, the platelet critical point is not less than 100×109/L

According to the condition, with as much psychological and physical preparation as possible, abnormal physiological conditions should be corrected as soon as possible to create surgical conditions. pieces Rescue and prepare at the same time >Perform surgery at the same time as rescue - should not emphasize perfect preoperative preparation and delay the operation