fù chǎn kē xué
2 IntroductionObstetrics and gynecology is an important part of medical science, which is the study of women's unique anatomy, physiology, and the diagnosis, prevention, and management of diseases. It is divided into two parts: obstetrics and gynecology, obstetrics studies the physiology and pathology of women during pregnancy, childbirth and puerperium, including the physiology and pathology of the fetus and the newborn; and gynecology studies the physiology and diseases of the reproductive system of women in non-pregnant states, as well as the diagnosis, prevention and treatment of these disease conditions. Obstetrics and gynecology also includes a section on female family planning.
Although obstetrics and gynecology is primarily a discipline related to the female reproductive system, due to the holistic nature of the human body, both in pregnancy and non-pregnancy, women's reproduction and other systems have a close relationship. Dysfunction of the reproductive system can lead to dysfunction of other organs and systems, and other systemic disorders can also directly or indirectly cause dysfunction of the reproductive system, so in the study of obstetrics and gynecology must have a holistic view of the whole body, regardless of the examination, diagnosis and treatment of obstetrics and gynecology should pay attention to the whole body.
3 recordsAs far back as the Spring and Autumn Period and the Warring States period, China has long had a record of obstetrics and gynecology. The Yellow Emperor's Classic of Internal Medicine Su Wen - on the ancient theory of Tianzhen had the following exposition: "Women seven years old kidney gas, teeth more hair long; two seven and the days of the capricorn to, Ren pulse through, Taichong vein is full of menstrual affairs to time down, so there is a child ......, seven seven Ren pulse is weak, Taichong vein is weak, the days of the capricorn exhaustion, the ground is not passable, so the shape of the bad and childless. " Description of China's ancient people a long time ago clear women's menarche roughly at 14 years old, menopausal age roughly at 49 years old. During the Warring States period, there were already internal, external, gynecological, pediatric and other medical sub-specialties, and the Qin Yue Ren (magpie) was a famous doctor specializing in obstetrics and gynecology. In the Han Dynasty, Zhang Zhongjing's "The Essentials of the Golden Chamber" already contained the contents of pregnancy diseases, post-partum diseases, and miscellaneous diseases of women, specializing in pregnancy and vomiting, abdominal pain, bandhas, and amenorrhea. Sui dynasty Chao Yuanfang's "the source of all diseases and wait for the theory" as well as the Tang dynasty Sun Simiao's "Thousand Golden Essentials", will be listed in the first volume of the woman's fetus and childbirth. Chen Ziming of the Song Dynasty collected the views of various schools of thought, and wrote "The Complete and Good Formulas for Women", which is the first comprehensive obstetrics and gynecology book in China and one of the classics of Chinese medicine obstetrics and gynecology. He such as the Yuan Dynasty Yang Zijian's "ten births", the Ming and Qing Dynasty Wang Kendang's "Women's Medicine", Wu Zhiwang's "Jiyin Compendium", and Wu Qian's "Medical Zong Jinjian - Gynecology", etc., are still the main references for the study of the motherland of medicine, obstetrics and gynecology.
Obstetrics and gynecology in Western medicine began to be established around the eighteenth century and was introduced to China in the early nineteenth century. Yang Chongrui was the first to establish a midwifery school in China, and Wang Shuzhen and Lin Qiaozhi were early famous obstetricians and gynecologists in China, who made remarkable contributions to the development and improvement of obstetrics and gynecology in China. In old China, due to the long-term oppression of feudal rule and the influence of patriarchal ideology, the progress of obstetrics and gynecology was very slow. On the eve of liberation, there were only 80 maternity hospitals and maternity and child health care centers, 9 maternity and child health care centers or stations, with 1,736 beds (excluding beds for obstetrics and gynecology in general hospitals), less than 1,000 specialists engaged in obstetrics and gynecology, and only 1,000 or so midwives, and most of them were concentrated in a few big cities, with few obstetrics and gynecology specialists in the vast countryside. The level of surgical operations is very low, and difficult surgeries can only be carried out in a few hospitals, and the new method of delivery is far from being fully popularized, resulting in high maternal and neonatal mortality rates.
Over the past 30 years since the founding of New China, the Party and the People's Republic of China have consistently attached great importance to women's health. the Constitution adopted in 1954 explicitly stipulates that "Marriage, the family, motherhood, and childhood are under the protection of the State", and article 29 of the National Program for the Development of Agriculture (NPDEA), which ran from 1956 to 1967, explicitly states that "the protection of women and children is under the protection of the State". In article 29 of the National Agricultural Development Program from 1956 to 1967, it was clearly stated that "women and children shall be protected" and that "the principle of equal pay for equal work for both men and women shall be firmly applied to women's productive work". With the development of socialist construction and medical and health care, maternal and child health-care institutions at all levels have been established and improved, a large number of obstetrics and gynecology specialists have been trained, and specialized hospital beds and medical equipment have been expanded, leading to the rapid development of the specialty of obstetrics and gynecology. In addition to the general hospitals responsible for obstetrics and gynaecology in China, there are also hospitals specializing in obstetrics and gynaecology, research institutes, women's health-care centres, health-care centres and maternity hospitals, etc. At present, there are about 40,000 obstetrician-gynaecologists and gynaecologists graduating from medical schools throughout the country***, and there are 70,000 intermediate-level medical personnel engaged in obstetrics and gynaecology, 40,000 midwives, 700,000 midwives, and some 90,000-100,000 obstetrics and gynaecology beds. In terms of academic research, the National Society of Obstetrics and Gynecology of the Chinese Medical Association and provincial and municipal chapters were established, and the academic journal Chinese Journal of Obstetrics and Gynecology was founded. Academic conferences are often held to exchange experiences, formulate plans, and unify names, standards, and methods of record-keeping.
4 EtiologyAs a result of the importance of maternal and child health care, the promotion and popularization of scientific midwifery, improve the quality of obstetric work. At present, the general practice of early pregnancy (3 months) that is to start regular checkups for pregnant women, timely detection and correction of abnormalities, effectively reducing the incidence of preterm labor, fetal position errors, eclampsia and other common pregnancy and childbirth complications. The prevention and treatment of hypertensive syndrome of pregnancy, postpartum hemorrhage and heart disease in pregnancy have reduced the mortality rate of mothers with these complications. In recent years, research on perinatal medicine has been carried out, and some specialized hospitals with better conditions have gradually set up neonatology departments since the 1950s, accumulating a lot of experience in caring for premature infants, feeding them, keeping them warm, and preventing cross-infections, etc., and formulating a set of routines for the medical care of newborns and preterm infants. Since the 1970s, some hospitals have implemented centralized observation, care and treatment for high-risk newborns, and have produced their own warming boxes for preterm infants, neonatal laryngoscopes and tracheal intubation tubes, automatic respirators, pressurized oxygen devices, interoperable piston-closed blood-exchange devices, infusion micro-pumps, semiconductor thermometers and so on, which have improved the survival rate of newborns and preterm infants. Some hospitals apply electronic labor and delivery monitors, conduct electronic fetal monitoring, and carry out prenatal diagnosis of hereditary diseases and congenital malformations. Through clinical measurements of the pelvis of Chinese women and observation of labor charts, certain "obstetric physiological constants" of Chinese women have been obtained. As a result of the above work and the gradual popularization, China has gradually formed a perinatal monitoring and prevention system, focusing on the management of high-risk pregnant women and high-risk fetuses, so that the maternal perinatal and neonatal mortality rates have been reduced significantly.
After the liberation of China outlawed prostitution, the control of the spread of sexually transmitted diseases; the promotion of a new method of midwifery, reducing puerperal infections; strengthened the labor protection of women, so that the incidence of inflammation of the female reproductive system has been significantly reduced; caused by sexually transmitted diseases of the reproductive organs have basically been eliminated.
5 TreatmentThe prevention and treatment of gynecological tumors has reduced the prevalence and mortality rate of cervical cancer through the nationwide screening and treatment of common women's diseases and the strengthening of the treatment and follow-up of precancerous lesions. The five-year survival rate of radical surgery for cervical cancer has reached the international advanced level. In the field of radiation therapy, the Beijing-style radium injector has been created and popularized in many provinces and cities. Many hospitals have purchased 60-cobalt or 137-caesium intracavitary back-loading treatment machines and linear gas pedals, and the treatment methods are gradually approaching the international advanced level. In terms of experimental research, a mouse model of cervical cancer has been established, and the relationship between herpes virus type II and the pathogenesis of cervical cancer, as well as the ultrastructure of cervical cancer cells, have been studied in depth. The efficacy of high-dose chemotherapy for trophoblastic tumors has approached or even exceeded the international advanced level in some aspects.
In the large-scale prevention and treatment of uterine prolapse and urinary fistula, surgical operation has been revolutionized, conservative therapy has been developed, therapeutic effect has been improved, and some effective preventive measures have been proposed. The treatment of gynecological diseases with traditional Chinese medicine, such as the treatment of ectopic pregnancy by activating blood circulation and removing blockage, and the treatment of functional uterine bleeding by tonifying the kidney with traditional Chinese medicine, has achieved better results. In terms of basic theoretical research, the law of hormonal changes in women during normal menstrual cycle has been explored. The chemical synthesis of luteinizing hormone-releasing hormone was successful. Cytogenetic examination, ultrasound diagnosis, laser and endoscopy and other new technologies have also been applied in the field of obstetrics and gynecology.
6 PrecautionsWith the development of China's medical science and pharmaceutical industry, the technical level of family planning is also improving. 1953, the use of contraceptive devices and external medicine is more common, and only part of the use of intrauterine devices and tubal ligation; 1960, the implementation of negative pressure abortion; 1963, the beginning of oral steroidal contraceptives, and research on the use of methods to reduce the amount; 1969, the application of oral long-acting contraceptives and the application of the long-lasting contraceptive pill and the method of reducing the amount of use. Oral long-acting contraceptives and family visit pills were applied, and effective mid-term labor induction and anti-early pregnancy drugs such as smallpox pollen and guanhua were screened. At the same time, China also synthesized prostaglandins and applied them to the clinic. Ligation is constantly being improved, with small incision ligation, single ligation, tubal clip sterilization and so on. In recent years, many regions have applied laparoscopic tubal electrocautery and silicone ring sterilization, and phenol paste has been developed and injected into the fallopian tubes by uterine intubation for sterilization.
Through these measures, the national population growth rate decreased significantly. 1982 national natural population growth rate averaged 14.6 ‰, in 1983 Shanghai natural growth rate averaged 8.52 ‰, the lowest region in the country.