Clinical investigation of effect of different anesthesia on cesarean section perioperative coagulation function and D-dimer / 中国基层医药

Objective To investigate effect of different anesthesia on cesarean section perioperative coagula-tion function and D -dimer,to provide a reference for clinical treatment.Methods 120 cases of cesarean section patients were selected,according to the anesthesia they were divided into observation group and control group.Obser-vation group (70 cases) used combined spinal epidural anesthesia,the control group(50 cases) used epidural anes-thesia.The prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),fiber clinical indicators fibrinogen (Fbg),DD,analgesia and its complications were compared between the two groups.Results Before surgery,PT,APTT,TT,Fbg had no statistically significant differences between the two groups (P >0.05).6h, 24h after operation, PT,APTT,TT of the observation group were (13.23 ±1.86) s,(31.18 ±5.94) s,(15.52 ± 2.55)s;(12.85 ±1.94)s,(29.74 ±5.52)s,(14.68 ±3.15)s,which were lower than the control group,the differ-ences were statistically significant (t =3.294,4.546,4.143,3.656,3.435,3.115,all P 0.05).In the observation group,the incidence rates of pain level 2,3 were 41.43%,30.00%,compared to the control group showed no significant difference (P >0.05). Deep vein thrombosis was not found in the observation group,the control group confirmed one case of femoral vein thrombosis,the incidence of venous thrombosis in the two groups showed no significant difference ( P >0.05). Conclusion Combined spinal epidural anesthesia,epidural anesthesia can both prevent cesarean section patients from perioperative hypercoagulable state,reduce the incidence of thrombotic complications,epidural anesthesia is the preferred method.

Exploration on the coaching of hematology clinical practice for undergraduate students of clinical medicine / 中华医学教育探索杂志

[Abatract] In order to improve the result of clinical practice for undergraduate students of clinical medicine, combined with the professional characteristics of hematology and teaching syllabus, Hematology Department in the First Affiliated Hospital of Dalian Medical University developed practi-cal teaching content and tried using a variety of teaching methods and teaching means such as multi-media aided teaching, case teaching and simulation teaching method and so on. Besides, multiple station examination was established; teaching feedback and supervision were strengthened. The prac-tice proved that the reform measures were conducive to the cultivation of medical students' practical skills and clinical thinking, which helped to speed up the transformation from the students to the role of doctors.

Clinical investigation of different fentanyl medication methods on propofol intravenous anesthesia painless abortion / 中国基层医药

Objective To investigate different fentanyl medication methods on propofol intravenous anesthe-sia painless abortion,to provide a reference for clinical treatment.Methods 1 20 patients undergoing painless abor-tion were selected,according to the random number table they were divided into Ciliao point group,subcutaneous group,intravenous injection group,40 cases in each group.Intravenous injection group used intravenous anesthetic propofol,Ciliao point group used Ciliao hole injection anesthesia,subcutaneous group used fentanyl anesthesia subcu-taneous injection.The anesthesia,analgesia and other clinical indicators of complications were compared among the three groups.Results The anesthesia excellent and good rate of Ciliao point group was 97.50%,which was higher than the subcutaneous group,intravenous injection group,the differences were significant(χ2 =4.1 32,3.894,all P 0.05).Postoperative 4h,8h,VAS scores of Ciliao point group were (2.32 ±0.56)points,(1 .1 3 ±0.23)points,which were lower than those in the subcutaneous group,intravenous injection group,the differences were significant (t =8.656,8.843,6.587,6.335,all P <0.05).The propofol use times,the amount of Ciliao point group were (1 .1 4 ±0.1 4),(1 1 6.37 ±1 4.35)mg respectively,which were less than those in the subcutaneous group,intravenous injection group,the differences were significant (t =6.645,5.587,6.1 32,5.854,all P <0.05).The incidence rate of adverse reaction of Ciliao point group was 2.50%,which of the subcutaneous group was 20.00%,which of the intravenous group was 25.00%,the differences were statistically significant (χ2 =6.596,7.454,all P <0.05).Conclusion Fentanyl uased at Ciliao point can enhance the clinical effect of anesthesia with less postoperative pain and reduce incidence of adverse reac-tions,it is worthy of clinical application.