基于院内网的信息资源库在普外科数字化手术教学中的应用

围绕手术教学的特点，阐述数字化学习理念及其在普通外科手术教学中的独特优势。介绍基于院内网的普外科手术教学信息资源库的构建方案，及其在普外科数字化手术教学中的应用过程及评价方法，并对初步应用效果进行评价，旨在改善普外科手术教学效果。     

普外科手术患者围手术期心理状态分析和护理对策

目的探讨普外科手术患者围手术期的心理状态及相应的护理对策。方法对246例普外科患者的围手术期心理状态进行综合分析,并采取针对性的心理护理措施。结果经过围术期有针对性的护理后,患者的心理状态得到明显改善,积极配合治疗和各项护理操作,降低了手术的风险和术后并发症的发生。结论对围术期患者实施个性化的心理护理干预可有效的调整患者的心理状态,从而积极地配合手术治疗,对于提高疗效和患者的满意度以及减少并发症具有积极地临床意义。     

以问题为基础学习教学方法在普外科临床见习教学中的应用

目的：探讨五年制口腔医学专业学生普外科见习教学中以问题为基础学习教学方法的应用及其效果分析。方法以新疆医科大学第一附属医院普外科见习的五年制口腔医学专业101名学生为研究对象，引入以问题为基础学习教学方法，将学生分成2组，以问题为基础学习教学组（PBL教学组）49人，传统教学组52人，两组学生在普外科学见习期间，分别采用PBL教学方法和传统教学方法。结果以问题为基础学习教学方法活跃了课堂气氛，充分发挥了学生的主观能动性，学生在教师的引导下学习正确分析病例、作出正确的诊断和治疗计划，提高了见习教学的效果。结论以问题为基础学习教学方法增强了学生学习的动力，提高了学生学习的兴趣和解决实际问题的能力，通过理论知识与实践的结合培养了学生的临床思维，为医学生成为一名合格的医生奠定了基础。     

Stress hyperglycemia in general surgery: Why should we care?

Aims

To determine the frequency of increasing levels of stress hyperglycemia and its associated complications in surgery patients without a history of diabetes.

Outcome of perioperative hemostatic management in patients with hemophilia without inhibitors undergoing 161 invasive or surgical procedures

Perioperative management of persons with hemophilia (PWH) is a challenge for surgeons and hematologists. Reductions in mortality rate and complications have been achieved since the introduction of clotting factor concentrates (CFCs), which improve hemostatic control. However, there is no clear consensus on the optimal dosing of CFC administration. The aim of this study was to evaluate the outcome of PWH without inhibitors in patients undergoing invasive or surgical procedures. A total of 161 procedures, including 57 major and 104 minor ones were retrospectively reviewed. The characteristics of PWH, age at procedure, duration and total amount of CFC administration during the perioperative period, hemostatic adequacy, and complications were summarized. The study showed a low rate of bleeding (1.2%), infection (0%), thromboembolic event (0%), and inhibitor development (0%). The results revealed the doses and duration of CFC administration for several major and minor procedures which were capable of achieving excellent hemostatic control.     

Higher clinical performance during a surgical clerkship is independently associated with matriculation of medical students into general surgery

Background

The purpose of our study was to determine the predictive impact of individual academic measures for the matriculation of senior medical students into a general surgery residency.

Methods

Academic records were evaluated for third-year medical students (n = 781) at a single institution between 2004 and 2011. Cohorts were defined by student matriculation into either a general surgery residency program (n = 58) or a non–general surgery residency program (n = 723). Multivariate logistic regression was performed to evaluate independently significant academic measures.

Results

Clinical evaluation raw scores were predictive of general surgery matriculation (P = .014). In addition, multivariate modeling showed lower United States Medical Licensing Examination Step 1 scores to be independently associated with matriculation into general surgery (P = .007).

Conclusions

Superior clinical aptitude is independently associated with general surgical matriculation. This is in contrast to the negative correlation United States Medical Licensing Examination Step 1 scores have on general surgery matriculation. Recognizing this, surgical clerkship directors can offer opportunities for continued surgical education to students showing high clinical aptitude, increasing their likelihood of surgical matriculation.     

舒适护理在普外科腹腔镜手术中的干预效果

目的：分析研究舒适护理方法对接受普外科腹腔镜术的患者产生的临床护理效果。方法随机抽取2014年5月—2016年2月该院收治的96例接受腹腔镜手术的病人作为研究对象，根据护理方式的差异，将其分为观察组(n=48)和对照组(n=48)，对照组予以常规护理，观察组在常规护理基础上予以舒适护理，对比两组护理满意度、术后并发症出现率、术后舒适度、平均住院时间。结果观察组护理满意度为97.9%，明显高于对照组的81.2%，比较差异有统计学意义(P<0.05)；观察组术后并发症出现率明显低于对照组，术后舒适度明显高于对照组，并且平均住院时间也明显短于对照组患者，比较差异有统计学意义(P<0.05)。结论对普外科腹腔镜术病人采取舒适护理措施，能够使其舒适度过整个围手术期，同时提高患者护理满意度，减少术后并发症的出现，促进患者早日康复，临床应用价值非常高。     

中西医结合治疗普外科腹部手术后早期炎性肠梗阻的临床疗效

目的 探究对普外科腹部手术后早期引发炎性肠梗阻患者使用中西医结合治疗的效果.方法 在本院行普外科腹部手术的患者中选取90例作为此次研究对象,分为A、B两组,每组45例.B组使用西医方法治疗,A组使用中西医结合方法治疗,对比两组患者治疗后的效果、不良反应的发生情况,以及肛门排气时间、肠鸣音消失时间、症状消失时间、治疗时间等临床指标.结果 治疗后,两组患者均未发生明显不良反应;而A组肛门排气时间快于B组[(3.03±0.98)d vs.(6.58±1.25)d],肠鸣音消失时间快于B组[(2.10±0.87)d vs.(5.67±1.36)d],症状消失时间快于B组[(6.14±0.56)dvs.(8.24±1.57)d],治疗时间短于B组[(11.01±2.14)d vs.(15.02±2.68)d],差异均有统计学意义(P＜0.01);治疗总有效率高于B组(95.56％ vs.80.00％),差异有统计学意义(P=0.02);梗阻缓解情况优于B组,差异有统计学意义(P＜0.05).结论 在普外科腹部手术后早期给予患者中西医结合治疗,能够有效改善患者炎性肠梗阻症状,提高其治疗效果,加快患者病情恢复,值得推广.