简介:[摘要]目的 分析微创经皮肾镜(mini-PCNL)在儿童上尿路结石中的应用效果。方法 选取院内上尿路结石患儿50例行对比调查,随机分为2组,对照组行标准通道经皮肾镜碎石治疗,观察组行mini-PCNL治疗,统计组间疗效相关指标。结果 观察组中有1例患儿体内残留结石,对照组中有2例患儿体内残留结石,组间结石排净率对比有差异性;观察组中1例患儿术后出血,平均出血量122.25±6.35ml;对照组中6例患儿术后出血,平均出血量151.15±6.05,组间出血率及出血量对比有差异性。结论 微创技术在尿路结石治疗中应用广泛,将微创经皮肾镜应用到儿童上尿路结石治疗中疗效显著,不容易出现术后出血问题,安全性较高。
简介:摘要目的探讨Mini-CEX量表在儿科临床实践中的可行性及应用效果。方法对2016年3月至2017年9月在北京大学第三医院儿科进行北京市住院医师规范化培训的住院医师,在每季度出科考核中应用Mini-CEX结构式表格评估其临床能力,评估其作为培训指导和考核方式的效果。采用SPSS 25.0软件进行t检验。结果共在7次出科考核中引入Mini-CEX量表,共有36名住院医师参与测评,完成量表110份。与2016年度相比,2017年度的Mini-CEX量表在问诊技巧[(7.4±0.9)vs. (7.7±0.7)]、体格检查[(7.5±1.1)vs. (7.6±0.9)]、临床判断[(7.5±0.9)vs. (7.6±0.9)]、组织效能[(7.4±0.9)vs. (7.7±0.9)]、整体临床胜任力[(7.5±0.9)vs. (7.7±0.9)]方面均有不同程度的提高,但差异无统计学意义(P>0.05)。共有17人完成3次及以上的评估,与2016年度相比,2017年度Mini-CEX量表平均分在问诊技巧、组织效能、整体临床胜任力方面有显著提高。结论Mini-CEX量表简便易行,可能对儿科住院医师临床能力的提高有一定的帮助,可以作为对儿科住院医师临床能力进行评估的测评方法。
简介:摘要目的评价迷你临床演练评估(mini-clinical exercise assessment,Mini-CEX)在中医儿科学临床教学中的应用效果,进一步优化具有中医儿科学特色的Mini-CEX量表,提高教师对其内涵的理解。方法选择儿科临床实习本科生50名,随机分为Mini-CEX组和对照组,每组各25人。总共实习4周。通过临床综合能力考核评价Mini-CEX应用效果;通过对Mini-CEX量表中各项内容的认可度、优势及存在问题进行问卷调查,以了解学生对临床教学中引入Mini-CEX的评价。采用SPSS 17.0软件进行t检验和卡方检验。结果Mini-CEX组实习生临床综合能力考核总成绩及各分项成绩均高于对照组(P<0.05),同时对教学的满意度高于对照组(P<0.05)。通过问卷发现,学生对改进后的Mini-CEX量表中项目的认可度较高,尤其是临床沟通技能、人文关怀这一类"软能力",认为其适合中医儿科的实习学习及效果评价。结论Mini-CEX具有提升本科生临床综合能力、教学方法灵活、评价方式客观及注重医患沟通交流等技能培养的优势,值得在临床推广。
简介:AbstractBackground:The optimal treatment for large impacted proximal ureteral stones remains controversial. The aim of this study was to evaluate the efficacy, safety, and potential complications of mini-percutaneous nephrolithotomy (MPCNL) and retroperitoneal laparoscopic ureterolithotomy (RPLU) in the treatment of impacted proximal ureteral stones with size greater than 15 mm.Methods:A total of 268 patients with impacted proximal ureteral stones greater than 15 mm who received MPCNL or RPLU procedures were enrolled consecutively between January 2014 and January 2019. Data on surgical outcomes and complications were collected and analyzed.Results:Demographic and ureteral stone characteristics found between these two groups were not significantly different. The surgical success rate (139/142, 97.9% vs. 121/126, 96.0%, P = 0.595) and stone-free rate after 1 month (139/142, 97.9% vs. 119/126, 94.4%, P = 0.245) of RPLU group were marginally higher than that of the MPCNL group, but there was no significant difference. There was no significant difference in the drop of hemoglobin between the two groups (0.8 ± 0.6 vs. 0.4 ± 0. 2 g/dL, P = 0.621). The mean operative time (68.2 ± 12.5 vs. 87.2 ± 16.8 min, P = 0.041), post-operative analgesics usage (2/121, 1.7% vs. 13/139, 9.4%, P = 0.017), length of hospital stay after surgery (2.2 ± 0.6 vs. 4.8 ± 0.9 days, P < 0.001), double J stent time (3.2 ± 0.5 vs. 3.9 ± 0.8 days, P = 0.027), time of catheterization (1.1 ± 0.3 vs. 3.5 ± 0.5 days, P < 0.001), and time of drainage tube (2.3 ± 0.3 vs. 4.6 ± 0.6 days, P < 0.001) of MPCNL group were significantly shorter than that of the RPLU group. The complication rate was similar between the two groups (20/121, 16.5% vs. 31/139, 22.3%, P = 0.242).Conclusions:MPCNL and RPLU have similar surgical success and stone clearance in treating impacted proximal ureteral stones greater than 15 mm, while patients undergoing MPCNL had a lower post-operative pain rate and a faster recovery.
简介:【摘要】目的:探讨PBL教学法与Mini-CEX在骨科实习带教中的对比。方法:将我院2019年1月-2020年1月30例骨科临床实习生,数字表随机法分二组。对照组给予PBL教学法,实验组实施Mini-CEX教学法。比较两组带教满意度、骨科临床操作考核成绩、临床理论考核成绩。结果:实验组带教满意度高于对照组,骨科临床操作考核成绩、临床理论考核成绩高于对照组,存在显著差异,P<0.05。结论:骨科临床实习生实施Mini-CEX教学法效果确切,优于采用PBL教学法,可提高骨科临床实习生的理论以及临床技能掌握水平,使其更好胜任日后的工作,并提高其对带教方法的满意度。
简介:摘要:目的:探讨Mini-CEX情景模拟联合SPOC混合式教学模式在急诊科本科护生中的运用效果。方法:选取2019年1月-2020年1月在本院急诊科实习的64名本科护生,采取随机对照的方式,将其分为观察组和对照组,观察组采取Mini-CEX情景模拟联合SPOC混合式教学模式,对照组采取传统的教学模式,然后对其进行考核,对比评价两组护生的操作考核成绩及人文关怀能力。结果:观察组学生的操作考核成绩和人文关怀得分分别高于对照组,差异具有统计学意义。结论:将Mini-CEX情景模拟联合SPOC混合式教学模式应用到急诊科本科护理生中,可以有效地提高其操作水平和人文关怀能力。
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简介:【摘要】目的:评估实施迷你临床演练评估(Mini CEX)协同客观结构化临床考试(OSCE)在提升实习护生临床实践能力中的应用价值。方法:选取我院2020年4月至2021年10月实习护生150例,随机分两组,实习A组实施传统带教协同OSCE模式下的临床护理带教,实习B组实施Mini CEX协同OSCE模式下的临床护理带教,评估两组不同考核阶段实践能力考核结果差异。结果:入科考核中,两组临床实践能力考核评分比较,差异无统计学意义(P>0.05);期中考核、出科考核中,实习B组临床实践能力考核评分高于实习A组,差异有统计学意义(P<0.05)。结论:实习护生临床护理带教中,实施Mini CEX协同OSCE的带教模式,能够显著提升实习护生临床实践能力,该协同带教模式应用价值显著。