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1、妇产科学妇产科学Obstetrics and Gynecology 大连医科大学第二临床学院大连医科大学第二临床学院大连医科大学第二临床学院大连医科大学第二临床学院妇产科学教研室妇产科学教研室妇产科学教研室妇产科学教研室姜晓晶教授姜晓晶教授姜晓晶教授姜晓晶教授Obstetrics and Gynecology relates medicine,surgery and pediatrics.and it is important subject which has wide information 第一章第一章 绪绪 论论Chapter oneintroductionHistory Obstet
2、rics and gynecology were marked by technical,Obstetrics and gynecology were marked by technical,intellectual,and social innovation in the early modern intellectual,and social innovation in the early modern period.While female midwives continued to deliver period.While female midwives continued to de
3、liver almost all babies,both male and female writers sought to almost all babies,both male and female writers sought to improve obstetrical practice,and anatomists strove to improve obstetrical practice,and anatomists strove to understand the workings of the human body,including understand the worki
4、ngs of the human body,including the female sexual and reproductive systems.Although the female sexual and reproductive systems.Although historians argue about the actual extent of maternal historians argue about the actual extent of maternal mortality,it is clear from sources that women feared morta
5、lity,it is clear from sources that women feared losing their lives in childbirth and that most women knew losing their lives in childbirth and that most women knew personally another woman who died in childbirth or personally another woman who died in childbirth or shortly thereafter.Similarly,while
6、 the full extent of shortly thereafter.Similarly,while the full extent of neonatal death in early modern Europe will remain neonatal death in early modern Europe will remain unknown,it is clear that birth was far more hazardous for unknown,it is clear that birth was far more hazardous for babies tha
7、n for their mothers.babies than for their mothers.Obstetrics and gynecology were grounded in Obstetrics and gynecology were grounded in classical and medieval precedent.The first classical and medieval precedent.The first European vernacular work on obstetrics,European vernacular work on obstetrics,
8、Eucharius Roeslins Eucharius Roeslins Rosegarten,Rosegarten,was published in was published in German in 1513 and was reprinted at least another German in 1513 and was reprinted at least another twenty-four times up to 1608.Addressed to twenty-four times up to 1608.Addressed to midwives and married w
9、omen,it describes the midwives and married women,it describes the mechanics of labor and delivery,care of the mechanics of labor and delivery,care of the newborn,and common complaints in pregnancy.newborn,and common complaints in pregnancy.Roeslins son translated the work into Latin,and Roeslins son
10、 translated the work into Latin,and the book subsequently became a European best-the book subsequently became a European best-seller,translated into French,Dutch,Spanish,seller,translated into French,Dutch,Spanish,Danish,English,and Czech and republished into Danish,English,and Czech and republished
11、 into the eighteenth century.the eighteenth century.Although Roeslins work proclaimed itself to be for Although Roeslins work proclaimed itself to be for a popular or lay audience,it owed much to learned a popular or lay audience,it owed much to learned authorities.Scholarship suggests that the work
12、 authorities.Scholarship suggests that the work was not originally written for midwives but for was not originally written for midwives but for medical men.In his preface,Roeslin describes medical men.In his preface,Roeslin describes how how GalenGalen(129c.199 C.E.),Rhazes(Rz,c.(129c.199 C.E.),Rhaz
13、es(Rz,c.865between 923 and 935),865between 923 and 935),AvicennaAvicenna(Ibn Sn,(Ibn Sn,9801037),and Averros(Ibn Rushd,11261198)9801037),and Averros(Ibn Rushd,11261198)struggled to understand the human body,and then struggled to understand the human body,and then places his own work within this lear
14、ned masculine places his own work within this learned masculine lineage.Much of the book,including the lineage.Much of the book,including the illustrations,ultimately derives from classical illustrations,ultimately derives from classical antiquity,specifically fromantiquity,specifically from Gynecol
15、ogy Gynecology by by SoranusSoranus (c.100 C.E.).(c.100 C.E.).Indeed some historians have argued that contemporary midwifery practice was more sophisticated than Roeslins classically based text might suggest.Roeslin after all was working from texts,not from experience delivering healthy babies,and h
16、is preface suggests a scorn for the manual knowledge and skill midwives possessed.1818世纪末剖腹取胎术世纪末剖腹取胎术19781978年第一个试管年第一个试管婴儿路易布朗的诞生，产前诊断、胎儿宫内治婴儿路易布朗的诞生，产前诊断、胎儿宫内治疗疗 1940 1940年巴巴尼古拉的阴道宫颈细胞学检测年巴巴尼古拉的阴道宫颈细胞学检测9090年代的年代的TBSTBS系统，系统，CCTCCT（计算机辅助细胞检（计算机辅助细胞检测），测），ThinprepThinprep细胞涂片，肿瘤综合治疗、肿细胞涂片，肿瘤综合治疗、肿
17、瘤疫苗研究瘤疫苗研究 1909 1909年第一枚蚕肠线年第一枚蚕肠线IUDIUD含铜、含药形含铜、含药形状各异的状各异的IUDIUD，计划生育基础理论研究和临床技，计划生育基础理论研究和临床技术实施成为发展中国家的典范术实施成为发展中国家的典范 l l l妇产科学妇产科学 l l 医学科学重要组成部分医学科学重要组成部分 l 涉及面广、整体性强涉及面广、整体性强 l 与内科、外科并驾齐驱与内科、外科并驾齐驱 l 妇产科学范畴妇产科学范畴l研究妇女特有的生理和病理的医学学科研究妇女特有的生理和病理的医学学科 产科学、妇科学、计划生育产科学、妇科学、计划生育 产产 科科 学学l对象对象 l研究内容
18、研究内容l产科学产科学(Obstetrics)(Obstetrics)l 产科学基础产科学基础 l 生理产科学生理产科学 l 病理产科学病理产科学 l 胎儿及早期新生儿学胎儿及早期新生儿学 l 围生医学围生医学妇妇 科科 学学 l对象对象 l研究内容研究内容l妇科学（妇科学（Gynecology)Gynecology)l 妇科学基础妇科学基础 l 生殖器炎症生殖器炎症 l 生殖器肿瘤生殖器肿瘤 l 生殖内分泌疾病生殖内分泌疾病 l 生殖器损伤生殖器损伤 l 生殖器畸形生殖器畸形 l 其他（内异症）其他（内异症）l l l l l l l l 计划生育计划生育 l 避孕避孕 l 绝育绝育 l 优
19、生优生妇产科学特点妇产科学特点l妇产科学与其他学科密不可分妇产科学与其他学科密不可分 l妇产科学本身是个整体不可分割妇产科学本身是个整体不可分割 l妇产科学是临床医学又是预防医学妇产科学是临床医学又是预防医学 l l 产产 科科 学学 进进 展展(advance of obstetrics)产科理论体系转变产科理论体系转变 产前诊断及产前诊断及PGD 围生期胎儿及新生儿超声监测围生期胎儿及新生儿超声监测 胎儿宫内治疗胎儿宫内治疗 产产 科科 学学 进进 展展(advance of obstetrics)(advance of obstetrics)辅助生殖技术辅助生殖技术 妊娠合并症的诊断及处
20、理妊娠合并症的诊断及处理 剖宫产相关问题剖宫产相关问题 分娩减痛术分娩减痛术 围生期感染及围生期感染及STD妇科学进展妇科学进展(advance of gyn.)l普通妇科普通妇科 腔镜妇科腔镜妇科 内分泌妇科内分泌妇科 肿瘤妇科肿瘤妇科 创伤与修复妇科创伤与修复妇科如如 何何 学学 习？习？l1:1:两个阶段两个阶段 系统学习阶段系统学习阶段 毕业实习阶段毕业实习阶段 l l2:2:两个问题两个问题 教与学的问题教与学的问题 l l l 教教 学学 目目 标标l围绕教学大刚要求，组织教学围绕教学大刚要求，组织教学 l掌握基本理论、基本知识、基本技能掌握基本理论、基本知识、基本技能 l系统学习
21、系统学习+毕业实习毕业实习=合格医生合格医生 l l 教教 学学 方方 法法l1:1:系统讲授系统讲授 l2:2:专题讲座专题讲座 l 目的目的（1 1）了解学科最新发展动态）了解学科最新发展动态 l （2 2）临床工作焦点、难点问题）临床工作焦点、难点问题 l3:3:模拟查房模拟查房 l 效果效果（1 1）巩固、复习、提高）巩固、复习、提高 l （2 2）心理素质培养、锻炼）心理素质培养、锻炼 l （3 3）角色转化）角色转化 l l 教教 学学 手手 段段l1：多媒体动画、图片：多媒体动画、图片 l2：实体标本：实体标本 l3：手术实况直播：手术实况直播 l 电视剧电视剧 橘子红了节选橘子红了节选学学 习习 要要 求求l倡导一个理想倡导一个理想 两种精神两种精神 l理想：理想：攀登医学高峰攀登医学高峰 l精神：精神：脚踏实地的干劲脚踏实地的干劲 l 持之以恒的钻劲持之以恒的钻劲结结 语语l做人要知足做人要知足 l做事要知不足做事要知不足 l做学问要不知足做学问要不知足Thank you for your attention!