2 Introduction Obstetrics and Gynecology is an important part of medicine, and it is a subject that studies the anatomy, physiology, diagnosis, prevention and treatment of female-specific diseases. Divided into obstetrics and gynecology. Obstetrics studies the physiology and pathology of women during pregnancy, childbirth and puerperium, including the physiology and pathology of fetuses and newborns. Gynecology studies the physiology and diseases of female reproductive system in non-pregnancy state, as well as the diagnosis, prevention and treatment of these diseases. Obstetrics and gynecology also includes the part of female family planning.
Although obstetrics and gynecology are mainly related to the female reproductive system, due to the integrity of the human body, female reproduction is closely related to other systems, whether during pregnancy or not. Dysfunction of reproductive system can lead to dysfunction of other organs and systems, and diseases of other systems can also directly or indirectly cause dysfunction of reproductive system. Therefore, we must have a holistic concept when studying obstetrics and gynecology, and pay attention to the overall situation when examining, diagnosing and treating gynecological diseases.
3 Records As early as the Spring and Autumn Period and the Warring States Period, there were records about obstetrics and gynecology in China. The following statement has been made in Huangdi Neijing: "At the age of seven, women have strong kidney qi and long teeth; On the 27 th, the sun solstice, the pulse is connected, the pulse is too strong, and the month is in the present, so there is a child ... On the 77 th, the pulse is weak, the pulse is too weak, and the tunnel is impassable, so the shape is bad and there is no child. " It shows that the ancients in China made it clear long ago that the age of menarche for women was about 14 years old, and the age of menopause was about 49 years old. During the Warring States Period, there were internal medicine, surgery, gynecology and pediatrics. Qin Yueren (Bian Que) was a famous gynecologist. Zhang Zhongjing's synopsis of the golden chamber in Han dynasty has included pregnancy diseases, postpartum diseases and miscellaneous diseases of women, and specifically discussed pregnancy vomiting, abdominal pain, leukorrhagia and amenorrhea. The Etiology written by Chao in Sui Dynasty and Qian Jin written by Sun Simiao in Tang Dynasty both listed women's viviparous in the frontispiece. In the Song Dynasty, Chen collected all the theories of the past dynasties and wrote the Women's Prescription, which is the first comprehensive work of obstetrics and gynecology in China and one of the classic works of obstetrics and gynecology in traditional Chinese medicine. His works, such as Ten Productions written by Yang Zijian in Yuan Dynasty, Criteria for Gynecology Based on Syndrome Differentiation and Treatment in Ming and Qing Dynasties, Compendium of Benefiting Yin written by Wu, and Heart Therapy of Gynecology, are still the main reference documents for the study of TCM obstetrics and gynecology.
Western medical obstetrics and gynecology began in18th century, and19th century was introduced to China. Yang Chongrui first founded a midwifery school in China. He Lin was a famous obstetrician and gynecologist in early China, who made outstanding contributions to the development and perfection 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 development of obstetrics and gynecology was very slow. On the eve of liberation, there were only 80 maternity hospitals and maternity and child care centers in China, and 9 maternity and child care centers or stations, with beds 1736 (excluding beds in obstetrics and gynecology in general hospitals). At that time, there were less than 1000 specialists engaged in obstetrics and gynecology, and only 1000 midwives, most of whom were concentrated in a few big cities, and there were even fewer rural obstetrics and gynecology professionals. The level of surgery is very low, and difficult surgery can only be performed in a few hospitals. The new mode of delivery is far from being fully popularized, so the maternal and neonatal mortality rates are very high.
Since the founding of New China for more than 30 years, the Party and people have always attached importance to women's health. The Constitution adopted in 1954 clearly stipulates that "marriage, family, mother and children are protected by the state", and Article 29 of the National Agricultural Development Program from 1956 to 1967 clearly points out "protecting women and children" and "resolutely implementing the principle of equal pay for equal work for women's productive work". With the development of socialist construction and medical and health undertakings, maternal and child health care institutions at all levels have been established and improved, a large number of obstetrics and gynecology professionals have been trained, specialist beds have been expanded, and medical equipment has been added, which has enabled obstetrics and gynecology to develop rapidly. In addition to general hospitals, specialized hospitals, research institutes, women's health centers, health centers and maternity hospitals are also responsible for obstetrics and gynecology in China. At present, there are about 40,000 obstetricians graduated from medical colleges in China, 70,000 intermediate medical staff engaged in obstetrics and gynecology, 40,000 midwives, 700,000 midwives, and about 90-65,438+10,000 beds in obstetrics and gynecology. In academic research, the National Society of Obstetrics and Gynecology of the Chinese Medical Association and provincial and municipal branches were established, and the academic journal Chinese Journal of Obstetrics and Gynecology was founded. Convene academic meetings frequently, exchange experiences, make plans, and unify names, standards and recording methods.
Etiology Due to the emphasis on maternal and child health care, scientific delivery has been popularized and the quality of obstetric work has been improved. At present, pregnant women have been regularly examined from the early pregnancy (3 months) to find and correct abnormal conditions in time, effectively reducing the incidence of common pregnancy and puerperal complications such as premature delivery, abnormal fetal position and eclampsia. Prevention and treatment of pregnancy-induced hypertension syndrome, postpartum hemorrhage and pregnancy complicated with heart disease reduce the mortality rate of pregnant women with these complications. In recent years, research on perinatal medicine has been carried out. Some specialized hospitals with better conditions have gradually established neonatal departments since 1950s, and accumulated a lot of experience in nursing, feeding, keeping warm and preventing cross infection of premature infants, and formulated a set of routine medical care for newborns and premature infants. Since 1970s, some hospitals have made intensive observation, care and treatment for high-risk newborns, and made their own incubators for premature infants, laryngoscopes and endotracheal tubes for newborns, automatic ventilators, pressurized oxygen supply devices, closed exchange transfusion devices with interchangeable pistons, infusion micropumps and semiconductor thermometers, which have improved the survival rates of newborns and premature infants. Some hospitals use electronic delivery monitors to monitor the fetus electronically and make prenatal diagnosis of genetic diseases and congenital malformations. Some "obstetric physiological constants" of women in China were obtained through the clinical measurement of pelvis and the observation of labor chart of women in China. Due to the development and gradual popularization of the above work, China has gradually formed a perinatal monitoring and prevention system focusing on the management of high-risk pregnant women and high-risk fetuses, which has greatly reduced the perinatal and neonatal mortality of pregnant women.
After liberation, China banned prostitution and controlled the spread of sexually transmitted diseases; Popularize new delivery methods and reduce puerperal infection; The labor protection for women has been strengthened, and the incidence of female reproductive system inflammation has been significantly reduced; The inflammation of reproductive organs caused by sexually transmitted diseases basically disappeared.
5 Treatment Methods Gynecological tumor prevention and treatment Through the national survey and treatment of common diseases among women, the treatment and follow-up of precancerous lesions have been strengthened, and the incidence and mortality of cervical cancer have been reduced. The five-year survival rate of radical cervical cancer surgery has reached the international advanced level. Beijing-style radium implantation was pioneered in radiotherapy, which has been popularized and applied in many provinces and cities. Many hospitals have added intracavitary afterloading therapy machines and linear accelerators with 60 cobalt or 137 cesium, and the treatment methods are gradually approaching the international advanced level. In the experimental study, a mouse model of cervical cancer was established, and the relationship between herpesvirus II and cervical cancer and the ultrastructure of cervical cancer cells were deeply studied. The curative effect of high-dose chemotherapy for trophoblastic tumors is close to or even exceeds the international advanced level in some aspects.
In the large-scale prevention and treatment of uterine prolapse and urinary fistula, innovative surgical methods, the development of conservative therapy, improved the treatment effect, and put forward some effective preventive measures. Chinese medicine has achieved good results in treating gynecological diseases, such as promoting blood circulation and removing blood stasis to treat ectopic pregnancy, and tonifying kidney with Chinese medicine to treat functional uterine bleeding. In the aspect of basic theoretical research, the regularity of hormone changes in women with normal menstrual cycle is discussed. The chemical synthesis of luteinizing hormone releasing hormone was successful. New technologies such as cytogenetic examination, ultrasonic diagnosis, laser and endoscopy are also applied in the field of obstetrics and gynecology.
6 Precautions With the development of medical science and pharmaceutical industry in China, the technical level of family planning is constantly improving. 1953 contraceptives and external drugs are widely used, and intrauterine devices and tubal ligation are only partially used; 1960 induced labor by negative pressure; 1963 started taking oral steroid contraceptives, and studied the methods to reduce their use. From 65438 to 0969, oral long-acting contraceptives and drugs for visiting relatives were used to screen out effective drugs for induced labor and mid-term anti-early pregnancy, such as Trichosanthes, Wanhua and so on. At the same time, prostaglandin has been synthesized and applied in clinic in China. Ligation is also progressing, including small incision ligation, single ligation, tubal sterilization and so on. In recent years, in many areas, phenol paste has been developed by laparoscopic salpingectomy and silicone ring sterilization, and injected into fallopian tubes through intrauterine intubation for sterilization. Through the above measures, the national population growth rate has dropped significantly. 1982 The average natural growth rate of the national population was 14.6‰, and that of Shanghai was 8.52‰ in 1983, which was the lowest in the country.