目的 探讨加用网片盆底重建术（PROSIMA）治疗盆腔器官脱垂患者的围手术期护理方法。 方法 对2010年6月－2011年6月收治的23例盆腔脏器脱垂患者施行的PROSIMA护理措施进行回顾性总结。 结果 23例患者术后尿失禁症状明显好转，舒适感增加；仅1例发生尿潴留，予重置尿管后顺利排尿；治愈率达100%。术后6个月复查时均无阴道壁膨出或穹隆脱垂，未出现下尿路感染、网片侵蚀、下肢疼痛等并发症。 结论 有效的护理措施可减少PROSIMA术后并发症，对提高手术成功率、促进患者康复有明显作用。
ObjectivesTo systematically review the application of evidence-based medicine (EBM) combined with problem-based learning (PBL) method in clinical teaching.MethodsDatabases including WanFang Data, CNKI, VIP, CBM, PubMed and EMbase were searched to identify eligible randomized controlled trials that compared EBM plus PBL with traditional lecture based learning (LBL) method in clinical teaching from inception to March 28th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Statistical analysis was performed using Stata 14.0 software.ResultsA total of 33 randomized controlled trials with 2 855 students were included. The results showed that students in EBM combined with PBL group obtained better scores of specialized theory (WMD=6.87, 95%CI 5.08 to 8.66, P<0.001), skills examination (WMD=10.57, 95%CI 8.98 to 12.16, P<0.001) and case analysis (WMD=9.79, 95%CI 4.71 to 14.88, P<0.001), comparing with those in LBL group. Besides, EBM combined with PBL method improved students’ overall ability including independent learning capability, clinical thinking ability, problem-solving capability, literature exploring capacity, communication and presentation skills and team-work ability.ConclusionsApplication of EBM combined with PBL method can improve clinical teaching quality.
本文通过对我国卫生法规和文献复习的基础上,对我国平均住院日管理问题进行历史回顾，阐述缩短平均住院日的目的和意义,并以此证实在我国实施缩短平均住院日的重要性。
目的:探讨白内障超声乳化术中发生后囊破裂的原因及处理措施。方法:总结我科2006～2008年近3年间施行的白内障超声乳化术患者508眼,人为将超乳手术过程分为超声乳化、吸出皮质、植入人工晶体三个阶段,对发生术中后囊破裂的26眼患者进行原因分析。结果:发现后囊破裂可发生在手术每个阶段,发生原因多与术者操作技巧有关,少数与患者自身因素有关。结论:严格的筛选患者,提高手术技巧,医生高度的责任心,良好的超乳设备是预防及处理手术并发症的关键。