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Ministry of health of ukraine

Kharkiv National Medical University

 

Approved

on the methodical meeting Department of Oncology

Head of Department

MD, Professor VI Starikov

"30" August 2012

 

 

A methodical DEVELOPMENT

For independent work of students

 

Course 6

Faculty of Medicine (specialty "General Medicine", "Pediatrics", "Prophylactic medicine")

Study Subject: Oncology

Topic

Number of hrs

Topic 1. Emergency in Oncology

2

Theme 2. Emergency treatment for complications of chemotherapy and radiotherapy

2

Theme 3. Treatment of complicated forms of cancer

1

Theme 4. Palliative surgery

2

 

 

 

Kharkiv 2012

 

 

Background.

Exhaustion special features of anticancer therapy and start controlling disease progression demonstrates the need for the transition to palliative and symptomatic treatment aimed not to prolong life and to support its acceptable quality. Palliative and symptomatic treatment includes all the necessary types of care that may be required at this stage of the patient, including surgical techniques (overlay Stom, necrectomy, drainage, immobilization, etc.).

Study objective: Deepen the theoretical and practical knowledge of students from the technique of palliative surgical procedures.

Know:

1.       Features of the development of malignant tumors.

2.       Analyze the causes of abandonment of malignant tumors.

3.     understanding of the mechanism of complications diverse tumors that require palliative surgical procedures;

4.     ability to properly assess the clinical manifestations of the disease in its progression and justify the need for performance you's or another's palliative surgical procedures.

Be able to:

Conduct review of cancer.

Absorb the history and analyze it.

Evaluate the nature of complications of tumor

Perform the basis vni palliative surgical manipulation

 

Care patients with stoma

Various stoma (artificial breeding hole hollow organ to the skin) are common in cancer patients, among them distinguished: manger stoma (for food) - Gastrostomy, enterostoma; excretory stoma - Colostomy, enterostoma, cystostomy, nefrostoma; breathing - Tracheostomy. Also, sometimes used artificial exterior fistula: bile, pancreatic, pleural. Any stoma significantly affects the lifestyle of the patient, significantly degrading its quality, so the organization proper care of patients enables to provide a higher level of consumer and social adaptation.

Special attention should be given to ensure control over the stoma, getting rid of extraneous emissions and odor and skin care.

If Tracheostomy skin care by using protective fatty emollients creams, provides permanent removal of sputum using disposable napkins. Traheostomu can cover the gauze bandage, hidden behind a high collar or cervical scarve.

Gastro-or enterostoma well hidden under clothes, but need serious skincare that undergoes the annoying effects of gastric or intestinal contents. The skin of the stoma should be regularly washed with warm soapy water, process cushioning prtyzapalnymy ointments and creams and cover with a layer of protective ointment. Frequently changing dressings to avoid inflammation and foreign smell.

The basis for the care of colostomy in the abdominal wall is a correct application of the most suitable in each case kalopryyomnyka. Various modern models kalopryyomnykiv allow enough acceptable level of quality of life and social activities of patients. Very important to the skin around the colostomy hygiene: wash with warm water and soap, anti-inflammatory creams and ointments mazove protective coating.

If urinary stoma most problems related to ensuring integrity, preventing leakage of urine and prevention of infection. Having a permanent catheter in the bladder can lead to cystitis, accompanied by hematuria and ascending infection. To prevent cystitis bladder regularly (after 1-3 hours), washed with antiseptic solutions (furatsillin, betadin) prophylactically administered uroseptics (tsyston, Nitroxoline, furadonin etc.). The required constant monitoring catheter maneuverability, regular cleaning and, if necessary, replacement. In order to timely diagnosis of infection in 2-3 days performing urine. It is also necessary skin protection and care by mazovyh dressings.

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