Effects of Electrosurgery and Vaginal Closure Technique on Postoperative Vaginal Cuff Dehiscence

Background and Objectives:

The aim of our study is to evaluate the role of electrosurgery and vaginal closure technique in the development of postoperative vaginal cuff dehiscence.

Methods:

From prospective surgical databases, we identified 463 patients who underwent total laparoscopic hysterectomy (TLH) for benign disease and 147 patients who underwent laparoscopic-assisted vaginal hysterectomy (LAVH) for cancer. All TLHs and LAVHs were performed entirely by use of electrosurgery, including colpotomy. Colpotomy in the TLH group was performed with Harmonic Ace Curved Shears (Ethicon Endo-Surgery, Cincinnati, OH, USA), and in the LAVH group, it was performed with a monopolar electrosurgical pencil. The main surgical difference was vaginal cuff closure—laparoscopically in the TLH group and vaginally in the LAVH group.

Results:

Although patients in the LAVH group were at increased risk for poor healing (significantly older, higher body mass index, more medical comorbidities, higher blood loss, and longer operative time), there were no vaginal cuff dehiscences in the LAVH group compared with 17 vaginal cuff dehiscences (4%) in the TLH group (P = .02).

Conclusion:

It does not appear that the increased vaginal cuff dehiscence rate associated with TLH is due to electrosurgery; rather, it is due to the vaginal closure technique.     

《妇产科护理学》教学改革初探

目的对《妇产科护理学》的教学工作进行改革,提高学生的学习兴趣,提高教学质量。方法将58名2001级学生作为对照组,81名2002级学生作为观察组。对照组采用传统方法教学,观察组从《妇产科护理学》教材内容的分工、理论教学模式、见习课的安排方面进行改革。结果观察组学生的学习成绩明显高于对照组(P<0.05),且观察组学生对教学内容中的医疗护理知识融合程度、教学方法的应变性、见习课的安排及集中见习效果的评价,优良率分别为96.3%、85.2%、88.9%、92.6%。结论《妇产科护理学》是一门实践性很强的学科,对其教学工作进行改革可提高教学质量。     

认知参与度视角下妇产科护理学混合式教学模式构建与实践

目的 构建《妇产科护理学》线上线下混合式教学模式,并检验其实践效果.方法 以认知参与度的联通主义学习教学交互模型为理论基础,从教学模式理论框架的构建、教学组织形式和教学方法、教学过程设计和教学评价多个维度,构建《妇产科护理学》混合式教学模式,用于2015级和2016级共223名护理本科生.结果 2015级学生理论成绩为(75.97±9.03)分,2016级理论成绩为(78.45±10.86)分.85.1％学生认为教学模式可以推广到护理专业其他课程,94.9％学生认为教学模式促进了其认知参与;75.3％学生认为线上教学资源的形式和内容应进一步完善.结论 认知参与度视角下混合式教学模式,可提高《妇产科护理学》教学效果.     

《妇产科护理学》教学改革初探

目的对《妇产科护理学》的教学工作进行改革，提高学生的学习兴趣，提高教学质量。方法将58名2001级学生作为对照组，81名2002级学生作为观察组。对照组采用传统方法教学，观察组从《妇产科护理学》教材内容的分工、理论教学模式、见习课的安排方面进行改革。结果观察组学生的学习成绩明显高于对照组（P〈0．05），且观察组学生对教学内容中的医疗护理知识融合程度、教学方法的应变性、见习课的安排及集中见习效果的评价，优良率分别为96．3％、85．2％、88．9％、92．6％。结论《妇产科护理学》是一门实践性很强的学科，对其教学工作进行改革可提高教学质量。     

高职《妇产科护理》翻转课堂的实施与效果评价

目的探讨翻转课堂教学在高职《妇产科护理》教学中的应用效果。方法将102名学生按照班级分为翻转班与对照班,翻转班实施翻转课堂教学,对照班实行传统授课模式。结果翻转班的理论成绩和实践成绩显著高于对照班(均P0.01),教学后自我导向学习能力显著高于对照班(P0.01)。结论实施翻转课堂教学有利于提高学生的学习成效和自我导向学习能力,为学生的终身学习打下基础。