What is well-differentiated liver cancer? Introduction to key points of preoperative and postoperative care for liver cancer

There are many patients suffering from liver cancer. Recently, 30-year-old Xiao Zheng found out that he had liver cancer during a physical examination at his company. What was even more unbelievable to him was that the doctor diagnosed him with mid-to-late stage liver cancer. How could someone who never smoked or drank and had a very regular diet and sleep also suffer from liver cancer? During the operation, the doctor removed a tumor from Xiao Zheng's liver. This time the doctor was shocked: "I have been a doctor for so many years, and this is the first time I have encountered liver cancer that grows into a dark marble-like shape!"

In terms of size, the tumor was about the same size as a pig's heart, about 8 centimeters long, which was normal. But the color was neither grayish white nor light yellow. It was black, with clear lines on the surface, just like a black marble! After a 2-hour operation, the tumor was completely removed.

The postoperative pathology report showed well-differentiated adenocarcinoma. It turned out that the "black" color was caused by bile deposition. In addition, from the cross-section of the tumor, there were brown-yellow patches mixed in it. The report showed fatty degeneration, which explained the marble texture of the tumor surface.

What is well-differentiated liver cancer?

Liver cancer cells that differ very little from normal liver cells in morphology and characteristics are called well-differentiated liver cancer cells, and the liver cancer lesions formed by them are called well-differentiated liver cancer; conversely, they are called poorly differentiated liver cancer cells and poorly differentiated liver cancer. The so-called degree of differentiation of liver cancer cells refers to the degree of difference between these cancer cells and normal liver cells. The greater the difference, the lower the degree of differentiation, and the more malignant the liver cancer is; the smaller the difference, the higher the degree of differentiation, and the less malignant the liver cancer is.

Preoperative nursing preparation for liver cancer:

1. Nursing for sudden symptoms

During preoperative care, liver disease may cause a variety of critical complications. For example, when primary liver cancer ruptures and bleeds, acute peritonitis and internal bleeding may suddenly occur. Some patients may have massive upper gastrointestinal bleeding and hepatic encephalopathy. A small number of patients may also show symptoms of upper gastrointestinal bleeding due to bile duct bleeding.

2. Preoperative bowel preparation

For patients who undergo extensive liver tissue resection or hepatic vascular ligation and embolization, especially those with cirrhosis, necessary intestinal preparation should be performed 3 days before surgery to inhibit intestinal bacteria and remove intestinal feces, reduce abdominal distension and blood ammonia sources after surgery, and prevent complications such as hepatic encephalopathy. A gastric tube is generally required before liver surgery, and a urinary catheter is also required when necessary. The amount of blood transfusion during and after extensive liver resection surgery may be large. Sufficient blood should be prepared before surgery, preferably fresh blood, to avoid transfusion of a large amount of stored blood during surgery and cause coagulation disorders.

3. Liver function and nutritional care

Before surgery, you should pay attention to rest and actively correct malnutrition, anemia, hypoproteinemia and coagulation dysfunction, and take effective liver protection measures.

Postoperative care for liver cancer:

1. When the patient returns to the ward after surgery, monitor the patient's vital signs, make regular rounds and records, observe the patient's consciousness, skin color, urine volume, and incision exudate, and notify the doctor in a timely manner if there are any changes in the patient's condition.

2. Within six hours after the operation, the patient should lie flat without a pillow. If vomiting occurs, the head should be tilted to one side. Six hours after the operation, the patient can rely on a pillow and the head of the bed can be raised appropriately, so that the patient can take a semi-recumbent position, which can reduce the tension on the abdominal incision, relieve abdominal pain, and facilitate breathing, circulation, and drainage.

3. After surgery, instruct the patient to use the analgesic pump correctly. If the patient has obvious pain, the patient should notify the doctor. Pay attention to preventing and treating possible complications of analgesia, such as urine retention, vomiting, nausea, etc.

4. Patients who have had more than half of their liver removed should receive oxygen for at least 3 to 4 days to increase the blood oxygen content of the liver cells in the remaining liver.

5. Pipeline maintenance: Properly fix various pipelines to avoid compression and distortion, keep drainage unobstructed, and regularly observe and record the amount, color, and properties of the drainage fluid.