What should I pay attention to in my diet after aortic dissection surgery? How long will it take before I can get out of bed and move around?

Author: Zhao Hongxia, deputy chief nurse, Beijing Anzhen Hospital, Capital Medical University

Reviewer: Zhi Xiuyi, Chief Physician, Xuanwu Hospital, Capital Medical University

Surgery is an important method for treating aortic dissection. After the operation, the patient should pay extra attention to diet, exercise, bathing, blood pressure control, etc.

diet:

When the patient returns to the ward after surgery and is able to eat, you can let the patient drink water first. If he does not choke after drinking water, he can eat.

Start with liquid food, such as millet porridge and rice soup. If the patient still does not choke and has no abdominal distension or pain after eating, you can gradually transition from liquid food and semi-liquid food to soft rice and normal diet. This process takes about three days, which means that you can basically resume a normal diet three days after the operation.

Another point to note is to eat small and frequent meals. Because the patient completes the operation under extracorporeal circulation and general anesthesia, it takes a certain amount of time for the gastrointestinal tract to recover. Therefore, in the short period of time after the operation, it is necessary to eat small and frequent meals, 5-6 meals a day, and eat less each time.

Activity:

The current view is that early getting out of bed is encouraged after aortic dissection surgery.

First of all, getting out of bed and moving around will increase gastrointestinal function. If there is a drainage tube, it can also promote the discharge of effusion, including benefits for lung function. After getting out of bed and walking around, it will promote sleep, spirit, and digestion.

As long as the patient's muscle strength is restored, the condition is stable, and the circulation is stable, he or she is encouraged to get out of bed and move around 1-3 days after the operation.

Figure 1 Original copyright image, no permission to reprint

At the beginning, the patient can move his limbs in bed, then raise the head of the bed 30-45 degrees, then 90 degrees, so that the patient can gradually sit up, and then sit on the bed for 5-10 minutes, and then put his legs under the bed and sit for 5-10 minutes. During this period, there must be a nurse or family member to accompany the patient, and then the nurse will help the patient to stand up slowly. Be careful not to hold the patient's hand when standing up, because sometimes the patient may suddenly experience postural hypotension when standing up, causing fainting, so be sure to support the patient instead of holding his hand.

If the patient has no problem standing, help the patient walk around the bed after 5-10 minutes. At this time, it should be noted that because the patient has many tubes, such as gastric tubes, urinary catheters, drainage tubes, central venous catheters, radial artery pressure gauges, etc., all tubes must be fixed to avoid them coming off.

From the bedside to the door, if the patient does not have any discomfort such as palpitations and shortness of breath, he or she can walk around in the ward. The whole process should be gradual and not rushed.

bath:

Bathing is also one of the issues that many postoperative patients are very concerned about.

Generally, the wound will recover in about 10 days after the operation, so it is recommended that patients do not touch water until 14 days later.

When you are discharged from the hospital, if the wound has not healed, you will put a waterproof film on the patient's wound to prevent it from coming into contact with water when you take a shower. You can also use a shower head to rinse from the back to avoid touching the wound.

In fact, as long as the condition and physical strength allow, you can take a bath two weeks after the operation. It is recommended to take a shower and sit down to take a bath, and never soak in a bath. If you feel uncomfortable, such as dizziness or blackouts during the bath, you should stop bathing immediately.

Figure 2 Original copyright image, no permission to reprint

If the wound becomes painful, oozing, red, or swollen at home, you should contact your doctor immediately and go to the hospital to check the wound.

1. Controls Blood Pressure:

There are many causes of aortic dissection, but the most important one is poorly controlled hypertension, which accounts for about 75%. Therefore, it is particularly important to control blood pressure for patients after aortic dissection surgery. If patients can control their blood pressure, blood lipids and blood sugar well, it will help reduce the recurrence rate of aortic dissection.

The 2018 "Guidelines for the Prevention and Treatment of Hypertension in China" stipulates that hypertension is defined as systolic blood pressure greater than 140 mmHg and diastolic blood pressure greater than 90 mmHg. For ordinary people, blood pressure should be controlled below 140/90 mmHg.

However, for patients undergoing aortic dissection surgery, it is recommended that systolic blood pressure be controlled below 120 mmHg and diastolic blood pressure be controlled below 80 mmHg, which is very meaningful for preventing the recurrence of aortic dissection.