病理及生育调节方面的学科产科Obstetrics妇科Gynecology计划.PPTVIP

TIME Not Exposed Exposed Outcomes Cohort Study, recruit at exposure, measure Outcome Advantage - Measures risk ratio (RR). Disadvantages - Time, n, cost. Cohort Study T1 T2 Case-Control Study, recruit on outcome, measure exposure (odds ratio OR). Advantages – time, n, cost. Disadvantage – no direct risk measurement. TIME No or Less Exposure Exposed Outcomes Cases Controls Case-Control Study T1 Sensitivity ：敏感性 proportion of the true cases detected. 如唐氏症筛查21三体风险度 a/a +c 假阴性低 Specificity：特异性 A specific test has few false positives, 如尿妊娠试验假阳性很低 假阳性低 Calculation－1 Proportion Survival Analysis Life table analysis (Always present 95% confidence intervals) Calculation－2 Crude Rates Adjusted Rates (standardised rates) Errors Random error Systematic errors (bias) Calculation－3 Life Expectancy Person years of life lost Disability adjusted life expectancy (DALES) Bias Sample Representative Size Controls Validity Gynecologic Events （可以做流行病调查的妇产科事件） Reproductive history Menarche, Menstrual cycle, Num of pregnancies, cesarean section, contraception, hormone using. Contraception Barrier, IUD, Oral pill, Sterilization 描述性研究 Cohort study队列研究 HRT STD Lifestyle Illness 国内外女性生殖系统疾病的疾病谱与国外的差异 浙江省孕产妇死亡率1996-2015 （1/10万） 浙江省新生儿、婴儿死亡率，5岁以下儿童死亡率2001-2015 （‰） 浙江省剖宫产率2008-2015（%） 妇女保健学：熊庆,吴康敏主编. 2007年 妇产科学：谢幸,苟文丽主编.妇产科学(第8版）2013年 Reference 1 2 OBSTETRICS GYNECOLOGY LIQIAN QIU 邱丽倩 Women’s Hospital Zhejiang University School of Medicine Women’s reproductive system diseases 女性生殖系统疾病 Epidemiology for the Gynecology 妇产科疾病流行病学 Content 妇产科学科研究 什么？What is topic 怎样学好这门学科? How to learn? 妇产科是专门研究女性特有的生理、病理及生育调节方面的学科 产科（Obstetrics) 妇科 (Gynecology) 计划生育 (Family Planning) 妇女保健 (Women’s Health, ~Maternal Health) 妇产科发展史Progress of OB/GYN 发展起源于产科：产科最早是一门技术（类似于工匠），民间叫接生婆（birth attendant)。 现代妇产科的发展是伴随着解剖学，麻醉学、药理学的发展而发展。 剖宫产技术（Caesarean section帝王切开)，子宫和附件的手术随现代医学的发展而发展。 近代妇产科学的突破 内窥镜技术 Endoscopy未来延伸机器人手术 辅助生育技术 Reproductive assistant technology 产前诊断技术