2. Clinical manifestations of advanced gastric cancer.

3. Laboratory and other examinations of gastric cancer

4. The main nursing measures of gastric cancer

5. Find out the reason in time.

6, chemotherapy care

1. Gastric cancer is a common malignant disease in the stomach, and its scope is constantly expanding, involving children, youth and the elderly. Under normal circumstances, the proliferation and apoptosis of gastric mucosal epithelial cells maintain a dynamic balance, which depends on the joint regulation of oncogenes, tumor suppressor genes and some growth factors. Many factors will affect this regulatory system and participate in the occurrence of gastric cancer. Clinical manifestations of gastric cancer: Gastric cancer can be divided into early and late stages. Cancer is localized, and its depth does not exceed mucosa and submucosa. Whether there is local lymph node metastasis or not, it is called early gastric cancer. The depth of advanced gastric cancer exceeds that of submucosa. The incidence of gastric cancer is mostly occult, and there are often no specific symptoms in the early stage. Even if there are symptoms, it is only mild epigastric discomfort, loss of appetite and fatigue, which is often misdiagnosed as chronic gastritis.

2. The main clinical manifestations of advanced gastric cancer are epigastric pain, emaciation, loss of appetite, progressive anemia, hematemesis and melena, but they are not unique to gastric cancer. Upper abdominal pain is the earliest symptom of advanced gastric cancer. At first, it showed discomfort and fullness in the upper abdomen, and then there was pain. Pain generally has little to do with diet, and symptoms are sometimes light and sometimes heavy. Sometimes symptomatic treatment can be relieved, but it is often not easy to disappear, and the pain continues gradually and cannot be relieved. Loss of appetite is often a prominent symptom, accompanied by gradual weight loss and weight loss. Nausea and vomiting When pyloric obstruction is caused by gastric antrum cancer, obvious nausea and vomiting may occur, and vomit can be eaten overnight. The amount of hematemesis and melena is usually small, and the vomit is mostly coffee-like. Black stool is rare, but stool occult blood test is always positive. Others: abdominal distension, diarrhea, constipation, low fever. A few patients only have clinical manifestations of fever. Signs Early gastric cancer may have no signs, and some middle and advanced gastric cancer may have palpable masses and upper abdominal tenderness. Cancer metastasis may show signs of organ involvement. Complications Massive bleeding, pyloric or cardial obstruction and gastric perforation are the main complications of gastric cancer.

3. Laboratory and other examinations of gastric cancer: Blood tests often include anemia, accelerated erythrocyte sedimentation rate, decreased albumin and electrolyte disorder. The fecal occult blood test is always positive. X-ray barium meal examination, especially the double contrast examination of gas and barium, is very helpful for the diagnosis of gastric cancer. Gastroscopy is an effective method to improve the early diagnosis rate of gastric cancer. Mucosal biopsy combined with cytology, pigment staining under endoscope, magnifying endoscope and ultrasonic endoscope can further improve the detection rate of early gastric cancer. Advanced gastric cancer often has typical manifestations of gastric cancer, and most of them can be diagnosed with naked eyes. Diagnostic essentials of gastric cancer Early diagnosis of gastric cancer is the premise of radical cure. All middle-aged and elderly patients who have been in good health in the past and have symptoms such as upper abdominal discomfort, pain, loss of appetite and emaciation in the short term should be examined in time. The diagnosis of gastric cancer mainly depends on X-ray barium meal examination and gastroscopy plus mucosal biopsy.

4. The main nursing measures of gastric cancer: strengthen the observation of the disease, prevent infection and other complications, observe the changes of patients' vital signs, observe the abdominal pain, abdominal distension, hematemesis and melena, and observe the improvement of symptoms and signs before and after chemotherapy. The resistance of patients with advanced gastric cancer decreases, and all parts of the body are prone to infection. Care and observation should be strengthened to keep the mouth and skin clean. Long-term bedridden patients should turn over regularly, massage, guide and assist physical activities to prevent pressure ulcers and thrombophlebitis. Rest Keeping a quiet, tidy and comfortable environment is conducive to sleep and rest. Patients with early gastric cancer can do some light labor and exercise after treatment, and pay attention to the combination of work and rest. Patients with advanced gastric cancer need bed rest to reduce physical exertion. Patients with cachexia should take good care of their skin, turn over regularly and massage the pressed parts. Do a good job in life care and basic care, so that patients can rest and treat in a comfortable mood. If there are complications such as fasting or gastrointestinal decompression, intravenous infusion should be given to maintain nutritional needs. Patients with nausea and vomiting should be given oral care. In addition, the environmental control of dining environment, vomit treatment and air circulation are also extremely important to promote patients' appetite. Diet should be aimed at satisfying patients' tastes and meeting the basic calorie needs of the body. Give high-calorie, high-protein, vitamin-rich and digestible foods, and avoid moldy, pickled and smoked foods. It is advisable to eat less and eat more meals, and choose the cooking methods that patients like to increase their appetite. Chemotherapy patients often lose appetite and should be encouraged to eat more. Pain nursing pain is the main pain of patients with advanced gastric cancer, and nurses should give spiritual support to relieve psychological pressure. Listening to music, taking a bath and other distractions or relaxation therapy can reduce the sensitivity of patients to pain and enhance their tolerance to pain. When the pain is severe, you can give painkillers according to the doctor's advice, observe the patient's reaction and prevent drug addiction. If the patient asks for painkillers too many times, besides considering the insufficient dosage of painkillers, he should also pay attention to the patient's emotional state and give him more time to talk. At the same time of therapeutic conversation, you can consult with the doctor and give back massage or take placebo as appropriate to meet the psychological needs of patients.

5. When there is stomach pain, stomach discomfort or digestive tract discomfort, you should go to the gastroenterology department of the hospital for gastroscopy or laboratory examination in time to find out the cause. And those who have irregular life, busy work, and long-term consumption of pickled products or moldy food should have a physical examination in time and make regular investigations. Although many people's stomachache is common gastritis, there are not a few who eventually develop into gastric cancer. Some chronic stomach diseases such as gastric ulcer, atrophic gastritis and gastric polyp have been considered as precancerous lesions. This reminds people who have a family history of stomach trouble and have repeated stomach pains to be vigilant. At present, the routine screening methods include: laboratory examination (including gastric cancer markers, gastric cancer monoclonal antibodies, gastric cancer occult blood bead method, gastric cancer probability computer model screening, etc. ), radiological examination, endoscopy and ultrasonic endoscopy. The main diagnostic methods of gastric cancer include gastroscope, X-ray diagnosis, double contrast examination of stomach, CT examination, endoscopic ultrasound and so on. Early gastric cancer is mainly found by gastroscopy. If gastroscopy is not done, early gastric cancer will further develop into advanced stage. At this time, there are often symptoms such as loss of appetite, tasteless food, satiety, anemia and emaciation. Some patients with gastric cancer often have gastric cancer syndrome, such as recurrent thrombophlebitis, acanthosis nigricans, skin fold pigmentation, dermatomyositis and so on.

6. Nursing care of chemotherapy Whether it is postoperative or non-surgical patients, local and systemic reactions caused by drugs should be closely observed during chemotherapy, such as nausea, vomiting, leukopenia, abnormal liver and kidney function, etc. , and should contact the doctor in time to take early treatment measures. Blood vessels should also be protected during chemotherapy to avoid blood vessels and local skin damage caused by leakage of liquid medicine. Once phlebitis occurs, local blocking with 2% lidocaine or wet compress with 50% magnesium sulfate should be performed immediately. Local hot compress and physical therapy are also feasible. If you lose your hair, you can let the patient wear a hat or wig to meet the self-image requirements. Psychological nursing when patients and their families know the diagnosis of the disease, they often can't face it calmly. Patients often show emotional denial, sadness, retreat and anger, and even refuse to receive treatment, while family members often feel anxious and helpless, and some even criticize medical activities. Nurses should give psychological support to patients and their families. Decide whether to tell the truth according to the patient's personality, outlook on life and psychological endurance. Patiently do a good job of explanation, understand all aspects of patients' requirements and meet them, mobilize patients' subjective initiative, and make them actively cooperate with treatment. Hospice care should be given to terminally ill patients so that they can spend their last days happily. Health education for patients with gastric cancer: instruct patients to pay attention to food hygiene, eat more fresh vegetables and fruits containing vitamin C, properly process food, and properly store whole grains. Eat less pickled products, smoked foods, fried foods and foods with high salt content, and don't eat moldy foods. Avoid irritating food and prevent overeating. Inform patients and their families about the factors related to gastric cancer.