检索结果-南通市图书馆

Maternal Deaths in Patients Evacuated to the Fousseyni Daou Hospital in Kayes over a Decade

Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1389-1398页

作者： Mahamadou Diassana Sitapha Dembele Ballan Macalou Alima Sibibe Falaye Keita Mamadou Haidara Famakan Kane Cheickna Sylla amadou bocoum Sanogo Siaka Amara Soumaila Traoré Department of Gynecology and Obstetrics Fousseyni Daou Hospital Kayes Mali Kayes Reference Health Centre Kayes Mali Reference Health Center of Kalaban-Coro Bamako Mali Bla Reference Health Centre Ségou Mali Department of Gynecology and Obstetrics Gabriel Toure University Hospital Center in Bamako Bamako Mali Department of Gynaecology and Obstetrics Regional Hospital of Sikasso Sikasso Mali

Introduction: Evacuation refers to the rapid transfer of a patient in an emergency, from one health center to another more equipped and better specialized. The objective of this study was to study maternal mortality in patients evacuated to the gynecology and obstetrics department at the Fousseyni Daou Hospital in Kayes over a period of 10 years. Materials and Methods: This was a descriptive, cross-sectional, retrospective study over nine years from January 1, 2011 to December 31, 2019 and prospective over one year from January 1, 2020 to December 31, 2020 involving all patients or parturients evacuated for obstetrical causes and died in the gynecology-obstetrics department of the Fousseyni Daou Hospital. Confidentiality and anonymity were respected. The processing and analysis of the statistical data was carried out using SPSS 20.0 software. Results: during our study period we identified 38,854 obstetric admissions including 6758 evacuations or 17.4%, among the 6758 cases of obstetric evacuations 284 died, a frequency of 4.2%. The maternal death audit committee of the Fousseyni Daou hospital in Kayes audited 101/284 cases (files) or 35.5% of which 64 maternal deaths (63.4%) were considered inevitable. In our study the 20 - 29 age group was more represented with 38%. 85% of the deceased patients lived in rural areas. In our series, 63.7% of the deceased patients had not had antenatal consultations (NPC). Eclampsia accounted for 26.8% of admissions diagnoses and 30.9% of causes of death. Seventy-two (72%) of deaths occurred postpartum, 15% perpartum and 13% prepartum. Direct obstetric causes were predominant at 65.1%. Conclusion: Indicators of maternal deaths among evacuated patients remain poor in our work. Maternal deaths were driven by socio-economic and cultural factors, but also by factors related to the health system.

关键词： Maternal Mortality Evacuation Kayes Hospital

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Socio-Epidemiological Aspects and Prognosis of Unassisted Deliveries Arriving at Fousseyni Daou Hospital in Kayes

引用

Open Journal of Obstetrics and Gynecology 2023年第2期13卷 360-371页

作者： Sitapha Dembele Mahamadou Diassana Ballan Macalou Alima Sibibe Albachar Hamidou Daouda Fomba Mamadou Haidara Famakan Kane Cheickna Sylla amadou bocoum Sanogo Siaka Amara Soumaila Traoré Department of Gynecology and Obstetrics of the Fousseyni DAOU Hospital Kayes Mali Kayes Reference Health Centre Kayes Mali Reference Health Center of Kalaban-Coro Bamako Mali Bla Reference Health Centre Ségou Mali Department of Gynecology and Obstetrics of the CHU GABRIEL TOURE Bamako Mali Department of Gynaecology and Obstetrics of the Regional Hospital of SIKASSO Bamako Mali

Introduction: The World Health Organization estimates that each year more than 20 million women suffer from the after-effects of unattended childbirth, of which 800 women die every day as a result of obstetric complications. Objective: Study the socio-epidemiological aspects and prognosis of unassisted deliveries arriving at the Fousseyni Daou De Kayes hospital. Materials and Methods: This was a descriptive, cross-sectional study with prospective collection, case-control that took place at the maternity ward of the Fousseyni Daou hospital in Kayes, from 1 January to 31 December 2021. Results: The frequency of unattended birth was 4.1%. The 30 - 35 age group was the most represented with 32.5%. In our study 58.1% of cases were out of school, 19.4% were primigestes and 39.4% were multiparous. In our series 60.6% of cases had given birth at home and 39.4% along the way. The majority of cases regretted having given birth without the assistance of qualified personnel in 45.6%. Maternal complications were dominated by perineal lesions in 14.4% of cases, haemorrhage of delivery in 25% of cases, severe anaemia in 30% of cases;16.7% of newborns were in poor condition, 13.6% were fresh stillbirths, 15.6% of newborns had obstetric trauma. The maternal death rate on arrival was 3%. Conclusion: The frequency of unassisted childbirth is high in the Kayes region. Its complications can be serious for both the mother and the newborn.

关键词： Childbirth Unassisted Prognosis Complications Kayes

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Epidemiological and Therapeutic Aspects of Proctological Pathologies in Pregnant and Postpartum Women at the Reference Health Center of Commune IV of Bamako District

引用

Open Journal of Obstetrics and Gynecology 2023年第4期13卷 752-766页

作者： Seydou Mariko Amaguiré Saye Dessé Diarra Sirima Diarra Mariam Tangara Brahima Dembélé Fanta Doumbia Moussa Samaké Abdou Guiré Yéli Dianessi Abdoul Razakou Dicko amadou bocoum Youssouf Traoré Adégné Togo Gynecology Department of Mali Bamako Hospital Bamako Mali Department of Gynecology and Obstetrics Reference Health Center of Commune IV Bamako Mali Department of General Surgery Centre de Santé de Référence de la commune IV Bamako Mali Department of Public Health Centre de Santé de Référence de la commune IV Bamako Mali Department of Gynecology and Obstetrics Center Hospitalier Universitaire (CHU) Gabriel TOURE Bamako Bamako Mali

Introduction: Painful proctological conditions that are far less pleasant can mar pregnancy and childbirth. In Mali, few studies have been carried out on proctological pathologies in pregnant women and in the postpartum period. Objective: To determine the frequency and identify the risk factors of anal pathologies during pregnancy and in the postpartum period in the obstetric gynecology department of the Centre de Santé de Référence de la comme IV du District de Bamako. Mali. Methods and Materials: Our observational study, a cross-sectional cohort survey over a period of nine (09) months from January 1, 2020 to September 30, 2020, was conducted in the obstetrics and gynecology department of the Health Center of Reference of Type IV of the District of Bamako. Results: The frequency of anal pathologies during pregnancy and in the post partum period was 24% (36/150). The different anal pathologies found were anal fissures, hemorrhoidal disease, anal incontinence and multiple anal pathologies with respectively 10%;6.67%;5.33%;2%. Chronic constipation (p = 0.003), a newborn weight > 3500 g (p = 0.000) to the occurrence of hemorrhoidal disease. For anal fissures, risk factors were noted such as (weight of the newborn > 3500 g (p = 0.002) and duration of fetal expulsion > 20 minutes (p = 0.000). Finally, a newborn weight > 3500 g (p = 0.000) and a maternal age of up to 30 years (p = 0.001) were associated with the occurrence of anal incontinence. Conclusion: Our study shows that anal pathologies affecting women's intimacy are frequent during pregnancy and in the postpartum period and are part of the many taboos difficult to address in our society.

关键词： Anal Pathologies Delivery Pregnancy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Management and Prognosis of Early Postpartum Hemorrhage in African Low Setting Health

引用

Open Journal of Obstetrics and Gynecology 2018年第1期8卷 1-9页

作者： Youssouf Traoré Ibrahima Téguété amadou bocoum Mamadou Traoré Seydou Dao Marion Koko Bomini Niani Mounkoro amadou Dolo Department of Gynecology and Obstetrics Gabriel Touré Teaching Hospital Bamako Mali Department of Gynecology and Obstetrics Yopougon Teaching Hospital Abidjan Cote d’Ivoire

Early postpartum hemorrhage is one of the major causes of maternal death in the world especially in developing countries. Its management often relieves resuscitation that is often difficult to set up in our countries and sometimes based on invasive and mutilate surgery. Objectives: The purpose of this survey was to report frequency of this pathology, to describe its management and the factors that influence the prognosis of early postpartum hemorrhage in low setting health in Africa. Method: Authors conducted a prospective study that analyzed early postpartum hemorrhage in the motherhoods of Gabriel Touré teaching hospital and community five health reference center of the district of Bamako. It took place from January, 2015 to December, 2016. The study concerned all the cases of early postpartum hemorrhage according to WHO definition. Statistical tests used were X2 or Fisher test, its 95% confidence interval (CI95%), p value was significant if Results: Early postpartum hemorrhage frequency has been 0.7% (62 cases for 8.885 deliveries). Sixty nine and one percent (69.1%) of patients have been blood fluid transfused. Obstetric treatment dominated by uterine revision (30.7%). Hysterorraphy (4.0%), hysterectomy (3.0%), suture of uterus injuries (15.7%), hypo gastric artery ligature (2.0%) and B-Lynch compression suture (2.0%) have been the main practiced surgical operations. No satisfy blood transfusion need was 26.9%. The main risk factors of early PPH were high parity (p = 0009;RR = 3.04;CI95% [2.80 - 5.11]), prolonged labor (p = 0004;RR = 4.00;CI95% [3.06 - 10.02]), oxytocin/prostaglandin use (p = 0003;RR = 1.47;CI95% [1.17 - 3.16]). Eleven of maternal occurred (11.8%). Conclusion: Early postpartum hemorrhage is still a severe event in developing countries especially. Its management sometime consisted to invasive cares. Maternal prognosis that is influenced by unsatisfied blood need and late management is marked by high lethality.

关键词： Early Postpartum Hemorrhage Risk Factors Surgery Maternal Death

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Sociodemographic and Clinical Aspects of Climacteric Syndrome of Menopause in the City of Kati in Mali Involving 113 Women

引用

Open Journal of Obstetrics and Gynecology 2023年第12期13卷 1938-1948页

作者： Daouda Camara Seydou Fané Yacouba Sylla Aly Daouda Oulogem Bintou Samaké Abdoulaye Sidibé Simaga Ismaël Soumana Oumar Traoré Saye Amaguiré Déssé Diarra amadou bocoum Koné Diakaridia Keita Sema Mahamadou Coulibay Haidara Ramatoullaye Ibrahima Téguetté Youssouf Traoré Major Moussa Diakité Referral Health Centre in Kati Kati Mali Gabriel Touré University Hospital Bamako Mali Fana Referral Health Centre Koulikoro Mali Joint Reference Health Centre V Bamako Mali Joint Reference Health Centre IV Bamako Mali Commune I/Bamako Referral Health Centre Bamako Mali Kalaban Coro Referral Health Centre Koulikoro Mali Koulikoro Referral Health Centre Koulikoro Mali

Objective: This paper aims to study the sociodemographic and clinical aspects of menopausal climacteric syndrome in the city of Kati in Mali. Patients and Methods: This was a quantitative descriptive and cross-sectional study, conducted in the city of Kati from February 1 to July 31, 2021. We included 112 menopausal women. Women were selected from a household survey using the sampling step. We were interested in conjugal, family and professional life, self-esteem and the state of health of women in general. Results: More than half of the women in our study were already postmenopausal (52.2%);the mean age was 50.5 years with the extremes ranging from 41 to 62 years. The majority of them were married (69.9%), housewives (43.4%) and Bambara (53.1%). The most common climacteric syndromes were: joint pain (65.5%), hot flashes (62.8%) and night sweats (56.6%). Genital-urinary syndromes (42.5%) were dominated by decreased libido (41.7%), urinary disorder (23%) and vaginal dryness (14.6%). Genitalia-urinary syndromes increased the frequency of disagreements;Pearson’s Chi-square = 33.63;ddl = 1;P = 0.001. There was a statistically significant relationship between night sweat, genital-urinary syndromes, joint pain, and increased disease frequency with, respectively: Pearson’s chi-square = 4.660;ddl = 1;P = 0.031;Fisher’s exact test, P = 0.001, Pearson’s Chi-square = 8.434;ddl = 1;P = 0.004. There was no statistically significant relationship between climacteric syndrome and family life, work life and self-esteem. Changes in the professional relationship between women and their co-workers included, respectively: arguments (50%);disagreements (25%) and disobedience (25%). Conclusion: Menopause deteriorates the quality of life of women who suffer in silence, hence the need to pay special attention to them.

关键词： Menopause Climacteric Syndrome Quality of Life Kati Mali

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Epidemiology, the Main Reasons and Maternal-Fetal Complications of Unassisted Childbirth in the Health District of V Bamako Commune, Mali

引用

Open Journal of Obstetrics and Gynecology 2020年第10期10卷 1381-1395页

作者： Soumana Oumar Traoré Cheickna Sylla Saleck Doumbia Alou Samaké amadou bocoum Seydou Fané Rokiatou Torian Sangaré Fatoumata Keita Ibrahima Tegueté Youssouf Traoré Niani Mounkoro Mamadou Traoré amadou Ingré Dolo Obstetric Gynecology Department The Reference Health Centre of Commune V Bamako Mali Obstetric Gynecology Department The Koutiala Reference Health Centre Koutiala Mali Obstetric Gynecology Department The Commune VI Reference Health Centre Bamako Mali Obstetric Gynecology Department The Gabriel Touré University Hospital Centre Bamako Mali

Objective: To describe the epidemiological aspects, to determine the reasons leading women to give birth outside of health facilities and to determine the maternal prognosis. Patients and Methods: This was a cross-sectional, analytical, quantitative and qualitative descriptive study over a period from 1 June to 31 December 2016 (7 months) on unassisted childbirth in the health district of commune V of Bamako. Results: We recorded 70 unsured deliveries, a frequency of 1.04% out of a total of 6719 deliveries. The extreme ages were 15 years and 41 years with an average age of 28 years. 90% of the birth attendants were married and 10% were single. The women's profession: 48% were housewives, 11% saleswomen, 13% hairdressers, 4% female teachers. Education level: 71% were uneducated and 29% educated. Among those who are educated, their level was primary in 50%, secondary in 32% and higher in 18%. 42% had done antenatal consultation. The main reasons: ignorance of work 44.3%;religious beliefs and societal burdens 10.0%;fear of caesarean section 4.3%;late-night birth labour 5.7%;lack of financial and/or transport means 17.1%; distance from the locality 2.9%;insecurity 2.9%. Maternal and perinatal prognosis: complications were mostly hemorrhagic and concerned 27 (39%) patients. These included uterine atony (13 cases), placental retention (8 cases), soft part lesions (6 cases). We have not recorded any m

关键词： Childbirth Unsured Reasons

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

HIV/AIDS Screening in the African Birthplace (Hospital in Kayes, Mali)

引用

Open Journal of Obstetrics and Gynecology 2021年第3期11卷 279-287页

作者： Mahamadou Diassana Ballan Macalou Sitapha Dembele A. Sidibe M. Diallo Soumana Oumar Traore Cheickna Sylla amadou bocoum Ibrahima Teguete Youssouf Traore Obstetrics and Gynecology Department at Fousseyni DAOU Hospital Kayes Mali Kayes Reference Health Centre Kayes Mali Reference Health Centre in Bamako Commune V Bamako Mali Department of Obstetrics and Gynecology at Gabriel Toure University Hospital Bamako Mali

Purpose: The purpose of this study was to determine HIV prevalence among participants admitted to the delivery room and recent birth attendants. Materials and Methods: This was a descriptive, cross-sectional, analytical study, with a prospective collection from February 1, 2018 to January 31, 2019 at fousseyni Daou Hospital in Kayes, Mali. Results: During our study period, we recorded 4269 deliveries. HIV-positive patients known before labour accounted for 0.21%. Four hundred and six participants received counselling/testing in the delivery room;of which 36 refused the test: 8.87% and 370 accepted or 91.13%. Thirteen patients tested positive or 3.51%. The 20 -

关键词： Screening HIV/AIDS Parturients Delivery Room

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

The Complications of Cesarean Section at Teaching Hospital Gabriel TOURE, Bamako Mali

引用

Open Journal of Obstetrics and Gynecology 2020年第4期10卷 546-557页

作者： Abdoulaye Sissoko Alassane Traore Ibrahim Kante amadou bocoum Soumana Oumar Traore Seydou Fane Daniel Dembele Aminata Kouma Mamadou Sima Fatoumata K. Tounkara amadou Fomba Ibrahima Teguete Youssouf Traore Soumaila Keita Niani Moukoro Teaching Hospital Gabriel TOURE Bamako Mali Teaching Hospital Bamako Mali Teaching Hospital Point G Bamako Mali District Hospital Commune V Bamako Mali Teaching Hospital Kati Bamako Mali Research Center CHU of Quebec University of Laval Quebec Canada

Cesarean operation permits to save the mother and fetus. However, in developing countries as ours, complications related to this cesarean are not to be neglected. It constitutes an important cause of maternal and fetal morbidity and mortality. Here we rapport the experience of our structure about the complications of cesarean. Objectives: The objectives of this study were to study the complications the complications of cesarean section at teaching hospital Gabriel TOURE, Bamako Mali. Materials and methods: We have carried out a cross sectional analytic study from January 1st?2003 to December 31st?2013. All the patients who gave birth by cesarean operation in gynecology-obstetric service of teaching hospital Gabriel TOURE were included during this period of study. Descriptive statistics were used, Chi-square test Pearson, and?Cochran Armitage test have?been used to calculate the P-value of trend. We performed multivariate analyses with a high alpha threshold of 10%, and then logistic regression multivariate. Results: We have registered 28,376 deliveries with 9509 cases of cesarean (33.5%) and a complication cesarean rate of 32% (3049/9509). The main risk factors for cesarean operation completions were adolescence primiparity, obesity, the non-realization of antenatal care, evacuations and co-morbidities. Intraoperative complications were dominated by hemorrhage 8.3% and bladder lesion 1.1%, whereas anemia (58.8%) and parietal infection (21.1%) dominated the postoperative complications table. The evacuation (Odds Ratio adjusted (ORa) = 1.96) as well pre-eclampsia/eclampsia?(ORa = 2.34) and the sicle cell disease (ORa = 9.99) were the main influencing factors of material death. Praevia placenta (ORa = 1.75) abruption placenta (ORa = 11.08) and fetal malformation (ORa = 2.21) dominated the influencing factors of perinatal death. Conclusion:?The cesarean complications rates were high in our improvement of the quality of antenatal care.?The reorganization and revitalization of the reference and against reference system

关键词： Cesarean Complication Risk Factors Morbidity Mortality

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Routine Screening for Cervical Cancer

引用

Open Journal of Obstetrics and Gynecology 2021年第7期11卷 922-928页

作者： Alassane Traoré Aphou Sallé Koné Sima Mamadou amadou bocoum Mamadou Bakary Coulibaly Koninba Diabaté Adama Diakité Kanté Ibrahim Seydou Mariko Idrissa Mama Diarra Service de gynécologie H&ocirc pital du Mali Bamako Mali Service de radiothérapie H&ocirc pital du Mali Bamako Mali Service de gynécologie-obstétrique Centre hospitalier et universitaire du Point G Bamako Mali Service de gynécologie-obstétrique Centre hospitalier et universitaire Gabriel Touré Bamako Mali

Objective: To describe the screening for uterine cancer by visual methods. Method: We conducted a prospective and descriptive study over a period of 12 months from January to December 2020. Direct observation of providers and interview of patients were performed for data collection. Results: Out of 3400 patients, 1024 were enrolled for the study, or 30.11%. The average age of the patients was 41 years with the extremes of 17 to 87 years. Women aged 40 to 45 were the most represented with 58.78%, (n = 602). Housewives 85.83% (n = 879), they had a primary education level in 71.09% of cases (n = 728), the vast majority were married 92.28% (n = 945). Multiparous represented 58.78% (n = 602) of the sample, nulliparous 18.26% (n = 187), women living in rural areas 30.17% (n = 309), in urban areas 69.82% (n = 715). The test was positive in 43 patients (4.19%) but squamocylindrical junction was not visible in 17% of cases. The preparation of acetic acid and lugol: good preparation in 100% of cases; the conditions of use are not r

关键词： Cervical Cancer Screening Hôpital du Mali

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Infectious Complications after Cesarean Delivery: Trends of Incidences, Risk Factors, and Prognosis in a Third Health Level Center in Africa. Case of Gabriel TouréTeaching Hospital

引用

Open Journal of Obstetrics and Gynecology 2018年第1期8卷 10-19页

作者： Youssouf Traoré Ibrahima Téguété amadou bocoum Malado Gamby Sidy Traore Soumaila Sanogo Seydou Zana Dao Mamadou S. Traoré Niani Mounkoro Department of Gynecology and Obstetrics Gabriel Touré Teaching Hospital Bamako Mali Department of Gynecology and Obstetrics Commune II Health Center Bamako Mali Department of Gynecology and Obstetrics Point G Teaching Hospital Bamako Mali

Post cesarean infections are the main sources of fever in the postpartum. We have undertaken this study in an African health setting where conditions of working are different from those in developed countries. Objectives: The objectives of this survey were to appreciate incidences, risk factors and prognosis of post cesarean infections. Method: We conducted a randomized historical cohort study in the department of gynecology and obstetrics of Gabriel Touré teaching hospital from 2010 to 2015. Data have been analyzed using X2 or Fisher test according their application conditions, p value Results: From 2010 to 2015 we performed 15,963 deliveries within 5263 cesareans sections (32.97%). According to all the deliveries, the global frequency of infection fluctuates from 1.5% in 2010 to 2.1% in 2015. The main risks that influenced the occurrence of post cesarean infections were: the context of cesarean section (RR = 2.05;CI95% (1.35 - 3.11);p 0.01), the prolonged labor (RR = 1.38;CI95% (1.05 - 1.81);p 0.01), the length of cesarean (RR = 3.00;CI95% (1.89 - 4.90);p 0.01), and genital bleeding (RR = 1.50;CI95% (1.10 - 1.90);p 0.01). The complications reported were endometritis (43.55%), wound infection (18.11%), breast infection (32.05%), puerperal psychosis (9 cases). We recorded six cases of pelviperitonitis and three cases of sepsis. Four cases of maternal death due to septic shock have been recorded (1.43%). Conclusion: Post cesarean infections constitute a real problem of public health in developing countries. In our survey, the main factors of infections have been context of cesarean, prolonged labor and length of cesarean. Endometritis, breast infection and wound infection are the major complications after cesarean section. The respect of protocol of the management of patients should permit to prevent this deadly complication.

关键词： Fever Postpartum Cesarean Endometritis Risk Factor Death Mali

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：