住院医师规范化培训是年轻医师进入临床的必经阶段,是临床思维形成和基本技能锻炼的重要时期.妇产科住院医师规范化培训的目标是培养医学生的岗位胜任能力.但近年来随着现代医学模式的转变,生物心理社会医学模式逐渐被人们重视,医学不只是一种技术而是一种社会活动,人文素质在医患之间起到了举足轻重的作用.人文素质差将无法满足岗位胜任力的要求.因此,只有能力与素质培养紧密结合,共同提高,才能培养出符合未来社会需求的卓越医学人才,将有助于构建和谐的医患关系.
妇产科住院医师规范化培训是培养妇产科专业医师的重要途径.目前妇产科住院医师规范化培训过程中存在教师带教意识不强、对学员临床技能和临床思维培训不充分、培训模式缺乏个体化差异等问题.可以尝试PBL教学联合导师制等优化对策,使住院医师在有限时间内高质量完成妇产科规范化培训.带教医师为了更好地教,需要转变教学理念,提高职业素养,真正做到理论知识与临床技能的传承.带教医师为了更好地学,需要认识到学是一种自我提升的过程.通过设置导师制切实提高教学质量,达到教学相长的目的.
目的：对剖宫产术后晚期产后出血患者进行发病时间及病因分析，进而探讨其最佳治疗方案。方法以2010年1月至2014年7月于我院住院救治的39例剖宫产术后晚期产后出血患者为研究对象。结果剖宫产术后晚期产后出血主要发生在产后2~4周内（共30例，占76.92%），主要病因为剖宫产后子宫切口感染、愈合不良（共22例，占56.41%）。31例经过促宫缩及抗炎药物治疗治愈，5例清宫后给予抗炎、促宫缩治疗治愈，3例经介入治疗治愈。结论剖宫产术后晚期产后出血多发生于术后2~4周内，子宫切口感染、愈合不良为主要发病原因，严格把握剖宫产手术指征，降低剖宫产比率，提高剖宫产手术技能是关键。对于出血量大，失血性休克患者经过药物对症治疗无效后经皮髂内动脉栓塞介入治疗是行之有效的治疗措施。
Objective: To explore the best treatment of pelvic abscess, through the analysis of laparoscopic operation and CT guided percutaneous puncture drainage effect in the treatment of pelvic abscess.Method: Clinical data of 69 patients suffering from pelvic abscess were analyzed retrospectively. Among them, 38 patients were given laparoscopic surgery treatment. 31 cases were given percutaneous puncture drainage treatment, under the CT guidance. The treatment efficacy of the two groups was compared.Result: The operation time was significantly longer than the interventional operation treatment, and the volume of hemorrhage during operation between the two groups were significantly different (P<0.01). The cure rate and effective rate were not statistically significant. The recurrence rate had significant difference (P<0.05).Conclusion: Under the CT guidance, percutaneous puncture drainage is an ideal method for treatment of pelvic abscess. Interventional treatment of pelvic abscess is smaller than the laparoscopic operation trauma. Treatment is equivalent to laparoscopic operation. The recurrence rate is significantly lower than that in laparoscopic operation.
Objective To investigate the causes, obstetric cesarean hysterectomy surgery is necessary, and operation precautions in operation. Methods From 2008 January to 2013 December in our hospital of caesarean operation, 20 cases of hysterectomy pa-tients. Results In the 20 patients with cesarean hysterectomy surgery, total labor number 0.028%. Among 10 cases of hysterectomy due to placental factors, accounting for 50%;5 cases of uterine atony, refractory disseminated intravascular coagulation hysterecto-my, accounted for 25%; 3 cases of amniotic fluid embolism underwent hysterectomy, accounted for 15%, due to rupture of the uterus, uterine malformation underwent hysterectomy patients in all 1 cases, accounted for the uterus excision of 5% of the total. Conclusion Cesarean section according to the cause and take corresponding after hemostasis, if still unable to control bleeding, in critical condition should be decisive for hysterectomy in order to save the lives of patients.
<正>近年来,随着科技水平的提高,微创的腹腔镜手术已经得到了患者的认同。而无气腹腹腔镜作为腹腔手术的重要组成部分,在20世纪90年代初应用于临床[1]。与有气腹腔镜相比具有更高的安全性、可操作性且经济实用,应用范围日益扩大。我院自2010年10月以来开展妇科无气腹腹壁下钢针悬吊法腹腔镜手术15例,现将护理体会报道如下。
