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Objective:To study the application value of flipped classroom teaching mode in clinical teaching of gynecological operating room.Methods:A total of 146 cases of gynecological operating room intern nursing students in The People's Hospital of Liaoning Province from January 2020 to April 2020 were selected as the research objects and divided into two groups according to different time. Before the flipped classroom teaching mode was carried out from January 2020 to February 2020, 73 cases were included in the control group, and after the flipped classroom teaching mode was carried out from March 2020 to April 2020, 73 cases were included in the observation group. The theory and operation scores of the two groups before and after teaching were compared, and the satisfaction of the practice nurses to the teaching and the evaluation of the observation group to the flipped classroom teaching mode were observed. After the teaching, the performances of the two groups of nursing students and the teaching satisfaction were compared using SPSS 22.0 to conduct t test, chi-square test and rank sum test. Results:The theoretical results[(88.52±8.99) points] and operational results[(89.79±7.51) points] of the observation group were significantly higher than those[(72.40±7.45) points and (73.66±7.77) points] of the control group, with statistical significance ( P<0.05). The teaching methods and self-evaluation satisfaction of the observation group were significantly higher than those of the control group ( P<0.05). Conclusion:The application of flipped classroom teaching mode in the teaching of nursing students in gynecological operating room can improve the students' operation and theoretical level, and the students have a high degree of recognition and satisfaction with the teaching mode.
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Objective:To analyze the causes and influencing factors of conversion from laparoscopic surgery to laparotomy.Methods:To analyze and summarize the clinical data of 84 patients who converted to laparotomy in 16 203 cases of laparoscopic surgery from August 2017 to August 2020 in the Department of Gynecology of the Affiliated Hospital of Qingdao University, each patient converted to surgery was matched with 2 patients who underwent simple laparoscopic surgery. The patients were divided into conversion to laparotomy group (84 cases) and control group (168) cases, and analyze the influencing factors of laparoscopic conversion to laparotomy. χ 2 test or corrected χ 2 test or Fisher exact probability method were used for the comparison of counting data between groups, and conditional regression analysis was used for the multivariate analysis of case control design. Results:The conversion rate of gynecologic laparoscopic surgery to laparotomy was 0.52%(84/16 203). The reasons for 84 cases of conversion from laparoscopic surgery to open surgery were as follows: pelvic adhesion 50.0%(42/84), unexpected malignant tumor 19.0%(16/84), tumor oversize or special shape and location 14.3%(12/84), hemostasis difficulty 7.1%(6/84), multiple uterine fibroids 3.5%(3/84), simultaneous surgery 3.5%(3/84), bladder injury 1.2%(1/84), and subcutaneous emphysema 1.2%(1/84) during the operation. There were no significant differences in body mass index and comorbidities (diabetes, hypertension, coronary heart disease, thyroid disease) between the two groups (all P>0.05). And the history of endometriosis was 36.9% (31/84) and the history of pelvic surgery in the transperitoneal group was 60.7% (51/84) higher than that in the conversion to laparotomy group of 20.8% (35/84), 30.6% (51/84) (χ 2=7.482, 21.42, P=0.006). The results of conditional regression analysis showed that that surgical history( OR=3.979, 95% CI 2.010-7.874, P<0.001 and thyroid history ( OR=15.333, 95% CI 1.087-216.346, P=0.005) increased the risk of conversion to laparotomy; Hypertension history ( OR=0.203, 95% CI 0.067-0.622, P=0.005) reduced the risk of conversion to laparotomy. Further analysis of which operation type affected the conversion to laparotomy showed that cesarean section ( OR=2.105, 95% CI 1.109-4.351, P=0.044), myomectomy ( OR=11.605, 95% CI 3.306-40.735, P<0.001), and ovarian cyst removal ( OR=7.914, 95% CI 2.157-21.037, P=0.002) affected the conversion to laparotomy. Conclusion:The main reason for conversion from gynecologic laparoscopic surgery to laparotomy is pelvic adhesion. The history of surgery and thyroid disease are the risk factors for conversion to laparotomy. Among them, myomectomy and ovarian cyst removal are important factors for conversion to laparotomy. Before operation, appropriate clinical operation methods should be selected according to the patient's medical history and condition to ensure the patient's safety.
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Objective To explore the value of primary and Advanced levels of laparoscopic simulating training in different seniority of gynecologic residents.Methods 77 residents in their first to forth training-year were divided into two groups:1-2 year resident and 3-4 year resident,trained with different levels of simulating training plans respectively and then assessed in the Department of Obstetrics and Gynecology in Peking University Third Hospital.Results The qualified rate of primary and advanced simulation training was 85.7％ and 57.1％ respectively.The qualified rate of primary training (80.4％ vs.100.0％,P=0.028) and advanced training (12.5％ vs.57.14％,P=0.000) were significantly different between 1-2 year residents and 3-4 year residents.The operative skills improved significantly in all the residents.In the 1-2 year residents,the scores of the primary training increased more obviously,while in the 3-4 year residents,the scores of the advanced training increased significantly.Conclusion It might be more effective for residents with different seniority to receive different levels of simulating training accordingly,so as to improve their laparoscopic operative skills more effectively.
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The difficult knowledge was analyzed in detail from such aspects as medical students' cognitive ability of the female pelvic anatomy structure,their learning of female reproductive endocrine physiology,their understanding of delivery mechanism and gynecological tumor clinical staging in gynecology and obstetrics.Through such strategies as the diversification of teaching to deepen students' cognition of female pelvic anatomy structure,presentation method to strength their understanding of the delivery mechanism and repeated memory to reinforce their learning of female reproductive endocrine physiology and smart memory to remember gynecologic oncology clinical staging,not only the students' learning ability was improved,but also the teaching quality was enhanced.
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Objective To explore the practicality and feasibility and evaluation of the team based learning method (TBL) combined with the clinical pathway leaning method (CP) in clinical teaching of department of gynecology and obstetrics. Methods Toltally 40 clinical specialist interns selected for the study were randomly divided into two groups (each 20) respectively, using TBL com-bined with CP teaching method and traditional teaching method, and to make analysis and comparisons on the above two teaching methods. Differences were compared with t testing. Meanwhile, a question-naire survey was carried out among students of TBL combined with CP teaching group for qualitative analysis of the implementation effect of TBL combined with CP pedagogy. (Qualitative analysis is the medical students' evaluation of teaching effect, without further statistical processing). Results The professional test results of TBL combined with CP teaching team were superior to the traditional teach-ing group [(83.95 ±7.63) vs. (72.00 ±5.26)] and the difference was significant by paired t tests and analysis (t=5.063,P<0.05). The knowledge contest results of TBL combined with CP teaching team were superior to the traditional teaching group(90 vs. 85,95 vs. 75,85 vs. 70). TBL combined with CP method has been recognized by 90% medical students and they think that most of their quality has been further improved. Conclusions TBL combined with CP method for the clinical teaching of de-partment of gynecology and obstetrics is practical and feasible, and should be widely applied.
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Objective To investigate the incidence and the drug-sensitivity results of mycoplasma infection in genital tract from the gynecological outpatients,in order to provide a laboratory evidence for clinical rational use of drug.Methods The drug sensitiv-ity kit was used for isolation and culture of mycoplasma,reproductive tract secretions samples of 1 067 cases of gynecological pa-tients were collected to do mycoplasma identification and drug sensitivity test.Results In 1 067 samples,the positive rate of myco-plasma were 659 samples,including ureaplasma urealyticum(Uu)positive rate was 72.99%(481/659),mycoplasma hominis (Mh) positive rate was 3.79%(25/659),Uu and Mh positive rate accounted for 23.22%(1 53/659).The drug sensitivity results of 12 kinds of antimicrobial agents showed that single infection Uu was more sensitive to josamycin,doxycycline,minocycline,tetracy-cline,clarithromycin,azithromycin and roxithromycin.Single infection Mh was more sensitive to doxycycline,josamycin,minocycline and tetracycline.Mixed infection of Uu and Mh was more sensitive to josamycin,minocycline and doxycycline.Conclusion The main pathogen isolated from patients infected with plasma in our hospital is Uu,whether single Uu or Uu,Mh mixed infection,there are differences in the sensitivity of antimicrobial,clinicians should use drug rationally according to the conditions of patients and drug sensitivity results to reduce drug resistance rate.
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Objective:To explore the impact of special rectification on antibiotics application in the patients during perioperative period with gynecologic typeⅡincision in our hospital. Methods:The antibiotics type, use frequency, expense, administration time, dosage, treatment course and combined medication were retrospectively compared between April to September in 2011(before the recti-fication) and April to September in 2013 (after the rectification). Results: After the special rectification, the total DDDs was de-creased from 1 564. 5 to 419. 3, the expense for antibiotics and all drugs was respectively decreased from (297. 5 ± 47. 1) yuan to (108. 3 ± 29. 6) yuan and (806. 4 ± 63. 1)yuan to (498. 1 ± 70. 2) yuan, the proportion of antibiotics was decreased from (36. 9 ± 9.1) % to (21.7 ±6.8) %, and the treatment course was reduced from (3.7 ±1.4)d to (1.5 ±0.6)d(P<0.05). The rational rate of administration time, dosage and combined medication was respectively increased from 67. 7% to 98. 6%, 81. 5% to 100. 0%and 41. 1% to 80. 7%(P<0. 05). Conclusion:Special rectification can effectively improve the rational antibiotics use in gynecology department of our hospital during perioperative period of type Ⅱincision.
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Objective To explore the effect of earplugs on the reduction of noises in the wards with a few patients after gynecological surgery.Methods Two hundred and fifty-four patients hospitalized in our hospital after gynecological surgery from March 2012 to May 2013 were divided into control group(n=124)and observation group(n=130). The observation group was managed with earplugs and the control group patients received routine nursing. The two groups were compared in terms of breathing,heart rate,blood pressure,24 h scores on anxiety before and after operation.Results The postoperative respiration,heart rate,blood pressure of the observation group patients was significantly lower than those of control group(all P<0.05),anxiety score was significantly lower than that of the control group(P<0.01). Conclusions Earplugs can create a quiet environment in wards with a few patients after gynecological surgery and help to stabilize vital signs and reduce anxiety.