上海市公共卫生临床中心妇产科2005～2007年住院患者疾病分布及产科结局

The disease distribution and gynecology ending of the gynecological patients received and treated in Public Health Clinical Center Aff＇fliated to Shanghai Fudan University from 2005 to2007

目的研究上海市公共卫生临床中心2005～2007年产科收治患者的疾病分布及其不同疾病对产科结局的影响。方法采用回顾性调查研究的方法，收集2005～2007年中心产科患者的病例资料进行分析。结果3年收治的患者中并存传染病1526例，其中肝炎1197例，肝炎后肝硬化20例，妊娠期肝内胆汁淤积症（ICP）132例，妊娠急性脂肪肝（AFLP）22例，妊娠肝损患者100例，妊娠并存艾滋病14例、结核病11例，妊娠合并麻疹15例，妊娠合并梅毒4例，妊娠合并水痘11例。肝病患者剖宫产率为81．2％，产后出血发生率为8．9％。结论研究发现近3年中心住院患者的疾病分布有较大的变化，同时发现妊娠肝病对妊娠结局影响最大；妊娠急性脂肪肝是产科肝病中造成急性肝功能衰竭的主要原因，对产科质量影响最大；妊娠合并艾滋病在疾病构成比中变化最大。提示应根据产科疾病分布的变化，采取针对性的医疗资源配置以及临床、科研及教学方案。

Objective To study the disease distribution of the gynecological patients received and treated in Public Health Clinical Center Affiliated to Fudan University, Shanghai from2005 to2007 as well as the influence of gynecology ending by different diseases. Methods The clinical data of Gynecology were reviewed retrospectively, which were from Public Health Clinical Center Affiliated to Fudan University, Shanghai, from2005 to2007. Results Among the patients during these three years, there are 1511 cases of hepatopathy （1197 of hepatitis,20 of posthepatitic cirrhosis;132 of intrahepatic cholestasis of pregnancy;22 of acute fatty liver of pregnancy; 100 of gestational hepatic injury）, 14 cases of pregnancy associated with AIDS; 11 cases of pregnancy associated with tuberculosis; 15 cases of pregnancy associated with measles;4 cases of pregnancy associated with lues; 1 l cases of pregnancy associated with chicken pox. The cesarean section rate was 81.2 percent and postpartum hemorrhage rate of 8.9 percent in Patients with liver disease. Conclusions The study found out that the disease distribution of the patients treated in recent three years has changed a lot; the liver of pregnancy imposed the biggest impact on the outcome of pregnancy; acute fatty liver of pregnancy is the main cause of obstetric liver disease in acute liver failure and has the severest impact on the quality of obstetric ; disease in pregnant women with AIDS constitutes the biggest part in the distribution, It is suggested that the allocation of medical resources, as well as clinical, research and teaching programs should be altered according to changes in the distribution of obstetrical diseases.