Umlando wohlelo lokusebenza kanye neqhaza leMicroscopes e-Neurosurgery

 

Emlandweni we-neurosurgery, ukusetshenziswa kweImicrosCasosUphawu oludabukisayo, ukuthuthuka kusuka enkathini yendabuko ye-neurosurgical yokwenza ukuhlinzwa ngaphansi kwamehlo anqunu kuya enkathini yesimanje ye-neurosurgical yokwenza ukuhlinzwa ngaphansi kweamantombazane. Ngubani futhi niniImicroscopeesQala ukusetshenziselwa i-neurosurgery? Iyiphi indima enayookokuhlinzwa ESCCONEudlalwe ekuthuthukisweni kwe-neurosurgery? Ngokuthuthuka kwesayensi nobuchwepheshe, kuzokwenzaI-MicrosCopeithathelwe indawo eminye imishini esezingeni eliphakeme? Lokhu kungumbuzo wokuthi yonke i-neurosurgeon okufanele yazi futhi isebenzise ubuchwepheshe bamuva kanye nezinsimbi emkhakheni we-neurosurgery, ukukhuthaza ukuthuthuka kwamakhono okuhlinza ama-neurosurgery.

1, umlando wezinhlelo ze-microscopy emkhakheni wezokwelapha

Ku-physics, ama-eyeglass lens amalensi anama-convex anesakhiwo esisodwa esinomphumela wokukhulisa, futhi ukukhulisa kwawo kulinganiselwe, kwaziwa njengezibuko ezikhulisayo. Ngo-1590, abantu ababili baseDashi bafaka amapuleti amabili we-convex lens ngaphakathi komgqomo we-cylindrical, ngaleyo ndlela asungula idivaysi yokuqala yokukhulisa isakhiwo sokuqala: Theamantombazane. Ngemuva kwalokho, ukwakheka kwe-microscope kwathuthukiswa ngokuqhubekayo, futhi ukukhuliswa kwandiswe ngokuqhubekayo. Ngaleso sikhathi, ososayensi ikakhulukazi basebenzise lokhuI-MicroSCOPE ECOMCOSITEUkubheka izakhi ezincane zezilwane nezitshalo, njengesakhiwo samaseli. Kusukela maphakathi kuze kube sekupheleni kwekhulu le-19, izingilazi ezikhulisayo kanye nama-microscopes asetshenziswe kancane kancane emkhakheni wezokwelapha. Ekuqaleni, odokotela abahlinzayo basebenzise isitayela sokukhulisa isitayela se-eyeglass ngesakhiwo esisodwa selensi esingabekwa ebhulohweni lekhala lokuhlinzwa. Ngo-1876, udokotela waseJalimane we-Saeemisch wenza "ama-microscopic" wokuhlinzwa wokuqala wezwe esebenzisa ingilazi ekhulayo ye-eyeglass ekhulisa (uhlobo lokuhlinzwa alaziwa). Ngo-1893, inkampani yaseJalimane uZeiss yasungulwaisikhombi se-binocular, ikakhulukazi esetshenziselwa ukubonwa kokuhlolwa emagumbini okucwaninga wezokwelapha, kanye nokubhekwa kwezilonda zeCorneal kanye ne-anterior Chamber Lensions emkhakheni we-Ophthalmology. Ngo-1921, kususelwa ocwaningweni lwelebhu nge-Animal Ingaphakathi Ear anatomy, iSweden Otolaryngologist Nylen yasebenza kahleI-Microsacular ehlitros steelcocularYakhelwe futhi yakhiqizwa eyedwa ukwenza ukuhlinzwa kwabezindaba okungapheli kubantu, okwakuyiphutha leqiniso. Ngomunye unyaka kamuva, udokotela ophakeme we-noylen uHlolmgren wethule aimidlaloekhiqizwe nge-zeiss egumbini elisebenzayo.

Ekuqaleni kwesikhathiImicroscopeeswayenezingqinamba eziningi, njengokuqina kwemishini, ukungakwazi ukuhamba, ukukhanyisa ama-axes ahlukile nokushisa kwe-lens yenhloso, inkambu yokukhuthala emincane, njll. Zonke lezi zizathu zikhawulela ukusetshenziswa okubanzi kweImicrosCasos. Kule minyaka engamashumi amathathu alandelayo, ngenxa yokuxhumana okuhle phakathi kwamaSurgeons futhiAbakhiqizi beMicroscope, ukusebenza kweImicrosCasosyathuthukiswa ngokuqhubekayo, futhimicroscopes okuhlinza ama-binocular, ophahleni olukhule ama-microscopes, amalensi wokusondeza, ukukhanyiswa komthombo wokukhanya kwe-coachial Ngo-1953, inkampani yaseJalimane iZeiss yakhiqiza uchungechunge lwe-specialidImicrosCasos Ehlise Okwe-OTogs, ikakhulukazi ilungele ukuhlinzwa ezindaweni ezijulile njengezindlebe eziphakathi nethambo lesikhashana. Ngenkathi ukusebenza kweImicrosCasosIyaqhubeka nokwenza ngcono, i-Mindset of Surgeons nayo iyashintsha. Isibonelo, odokotela baseJalimane Zollyner noWullstein bakucacisele lokhoImicrosCasoskumele isetshenziselwe ukuhlinzwa okwami ​​ulwelwesi nge-tympanic membrane. Kusukela ngawo-1950s, odokotela be-ophthalmologists bashintshe kancane kancane umkhuba ukusebenzisa ama-microscopes wezivivinyo ze-ophthalmic futhi wethulwaama-microscopes we-otosurgicalekuhlinzweni kwe-ophthalmic. Kusuka lapho,I-MicrosCopeisetshenziswe kabanzi emasimini e-otology kanye ne-ophthalmology.

2, Ukusetshenziswa kwezinto ezihlinzayo ku-neurosurgery

Ngenxa ye-neurosurgery, ukusetshenziswa kweImicrosCasones e-NeurosurgeryKuhamba kancane ngaphezu kwe-othology kanye ne-ophthalmology, kanti ama-neurosurgeons afunda kakhulu lobu buchwepheshe obusha. Ngaleso sikhathi,Ukusetshenziswa kwezinto microscopeeswayesekuseYurophu. I-American Ophthalmologist Perrit yethulwe okokuqalaImicrosCasosUkusuka eYurophu kuya e-United States ngo-1946, kubeka isisekelo se-American Neurosurgeons okufanele uyisebenziseImicroscopees.

Ngokombono wokuhlonipha inani lempilo yomuntu, noma yibuphi ubuchwepheshe obusha, imishini, noma izinsimbi ezisetshenziselwa umzimba womuntu kufanele zihlolwe izivivinyo zezilwane zokuqala kanye nokuqeqeshwa kobuchwepheshe kwabasebenza. Ngo-1955, i-American Neurosurgeon Malis yenze ukuhlinzwa kobuchopho ezilwaneni kusetshenziswa aimidlalo. UKurze, i-neurosurgeon eNyuvesi yaseCalifornia e-United States, wachitha unyaka ufunda izindlela zokuhlinza zokusebenzisa ama-microscope ngemuva kwesibona-microscope. Ngo-Agasti 1957, wenze ngempumelelo ukuhlinzwa kwe-neuroustic neuroma enganeni eneminyaka emihlanu esebenzisa iukuhlinza izindlebe, okwakuhlinzwa okokuqala kweMicroserlical. Kungekudala ngemuva kwalokho, uKurze wenza ngempumelelo i-anastomosis yezinzwa yezinzwa ebusweni enganeni esebenzisa aokokuhlinzwa ESCCONE, futhi ukululama kwengane kwakukuhle kakhulu. Lokhu bekungukuhlinzwa kwesiMicrosoft kweMicroSgical emhlabeni. Ngemuva kwalokho, uKurze wasebenzisa amaloli okufanele athwaleImicroscopeesezindaweni ezahlukahlukene ze-MicroseMicroSurgical Neurosurgery, futhi kunconyelwe ngokuqinile ukusetshenziswa kweImicrosCasosKwabanye ama-neurosurgeons. Ngemuva kwalokho, uKurze wenza i-cerebral aneurysm ehlekisayo ehlinza isebenzisa aokokuhlinzwa ESCCONE(Ngeshwa, akazange ashicilele noma yiziphi izindatshana). Ngokusekelwa kwesiguli se-Trigeminal Neuralgia, wasungula ilabhorethri yokuqala ye-Neurosurgery yokuqala yezwe ngo-1961. Kufanele ngaso sonke isikhathi sikhumbule umnikelo we-urze ku-Microsersergery futhi sifunde esigabeni sakhe sokwamukela ubuchwepheshe obusha nemibono. Kodwa-ke, kuze kube ekuqaleni kweminyaka yama-1990, amanye ama-neurosurgeons eChina awazange amukeleAma-microscopery ama-microscoperyukuhlinzwa. Lokhu bekungeyona inkinga ngeAma-microscope we-neurosurgeryuqobo, kepha inkinga ngokuqonda kwemibono ye-neurosurgeonons.

Ngo-1958, i-American Neurosurgeon Donaghy yasungula ukucwaninga okokuqala kwe-MicroS3 Emagameni okuqala, naye wahlangabezana nokudideka nobunzima bezezimali abaphezulu. E-Academia, wayehlala enombono wokusika imithambo yegazi evulekile ukuze akhiphe ngokuqondile i-thrombis kusuka ezigulini ezine-thrombosis ye-cerebral. Ngakho-ke wasebenzisana nodokotela ohlinza imithambo kaJacobson ocwaningweni lwezilwane nolokwelashwa. Ngaleso sikhathi, ngaphansi kwemibandela yeso elinqunu, imithambo yegazi emincane kuphela enobubanzi bamamilimitha ayi-7-8 noma ngaphezulu kungahle kuthathwe. Ukuze uzuze ama-anastomosisis wokugcina wokuphela kwemithambo yegazi emihle, uJacobson aqale azame ukusebenzisa isitayela sokukhulisa isitayela. Ngokushesha nje, wakhumbula esebenzisa iI-Microsoftukuhlinzwa lapho engumhlali. Ngakho-ke, ngosizo lweZeiss eJalimane, uJacobson waqamba umhlinzeki ophelile ophareji ophambana (I-nenkondlo) Kwama-anastomosis we-vascular, okuvumela odokotela abahlinzayo ababili ukuthi bahlinzwe ngasikhathi sinye. Ngemuva kokuhlolwa kwezilwane okubanzi, uJacobson washicilela i-athikili kuma-anastomosical we-MicroScicial Anastomosis wezinja nama-areteries angewona ama-carotid (1960), anezinga eli-100% le-apency le-vascular anastomosis. Leli yiphepha lezokwelapha elihlabayo elihlobene ne-MicroScisergical Neurosurgery kanye nokuhlinzwa kwemithambo. UJacobson uphinde waklama amathuluzi amaningi we-microserigical, afana nesikeya esingu-micro, abanikazi bamatilongo amancane, kanye nensimbi encane. Ngo-1960, uDonaghy wenza ngempumelelo i-cerebral artery ecleision umlomenhlako ngaphansi kweokokuhlinzwa ESCCONEisiguli esine-thrombosis ye-cerebral. URhoton ovela e-United States waqala ukutadisha ubuchopho u-Anatomy ngaphansi kwesibonakhulu ngo-1967, ephayona insimu entsha ye-MicroSMicroSRGICAL ANATOMY futhi enze iminikelo ebalulekile ekuthuthukisweni kwe-MicroSMirsergery. Ngenxa yezinzuzo zeImicrosCasoskanye nokwenza ngcono izinsimbi ze-MicroScial, odokotela abahlinzayo abaningi bayathanda ukusebenzisaImicrosCasosukuhlinzwa. Futhi ishicilele izindatshana eziningi ezihlobene nezinqubo zeMicrosercise.

3, Ukusebenza kwezinto ezihlinzayo ku-neurosurgery e China

Njengomshileko waphesheya kwesiShayina eJapan, uSolwazi Du Ziwei wanikela ngendlu yokuqalaMicroscope ye-Neurosurgicalfuthi kuhlobeneizinsimbi ze-microScisergicalUMnyango we-Neurosurgery waseSuzhou Medical College oxhumene nabo (manje uMnyango we-Nuurosurgery waseSuzhou University ehambisanayo nesibhedlela sokuqala) ngonyaka we-1972. Ngemuva kokubuyela eChina, okokuqala wenza ukuhlinzwa kwe-MicroSRANIAL NE-ANEURYSMS kanye nama-meningiomas. Ngemuva kokufunda ngokutholakala kweImicroscopes ye-Neurosurgicalkanye nezinsimbi ze-Microsersorgical, uSolwazi Zhao Yadu ovela eMnyangweni we-Neurosurgery waseBeijing YiWu Hospital wavakashela uSolwazi Du Ziwei waseSuzhou Medical College ukubheka ukusetshenziswa kweImicrosCasos. USolwazi Shi yuquan waseShanghai Huashan Hospital uvakashele uMnyango Wezomnotho waseShanghai UProfesa uProfesA Ngenxa yalokhu, igagasi lesingeniso, lokufunda, nokusebenzisaAma-microscopery ama-microscoperywabhekwa ezikhungweni ezinkulu ze-neurosurgery eChina, ezimaka ukuqala kwe-neurosurgery encane yaseChina.

4, umphumela wokuhlinzwa kwe-MicroserMirgery

Ngenxa yokusetshenziswa kweImicroscopes ye-Neurosurgical, ukuhlinzwa okungeke kwenziwe ngeso elinqunu kube okungenzeka kube ngaphansi kwezimo zokukhulisa izikhathi ezingama-6-10. Ngokwesibonelo, ukwenza i-pituitarymus filess nge-sinus ye-ethmoidal kungakwazi ukubona kahle futhi kususe ama-tumors asePilaitary ngenkathi evikela i-gland evamile ye-pituitary; Ukuhlinzwa okungeke kwenziwe ngeso elinqunu kungaba ukuhlinzwa okungcono, okufana nama-braintem tumors kanye nomgogodla umgogodla izintambo zamanje. I-Acadomian wang zhongcheng yayinezinga lokufa kwabantu ngo-10.7% ngokuhlinzwa kwe-cerebral aneurysm ngaphambi kokusebenzisa aama-microscope we-neurosurgery. Ngemuva kokusebenzisa ama-microscope ngo-1978, inani lokufa lahlelwa liye ku-3.2%. Izinga lokufa kokuhlinzwa okungahambi kahle kwe-artteriovenous ngaphandle kokusebenzisa aokokuhlinzwa ESCCONEkwakungu-6.2%, kwathi ngemuva kuka-1984, ngokusetshenziswa kweama-microscopery ama-microscopery, Izinga lokufa lancipha laya ku-1.6%. Ukusetshenziswa kweama-microscope we-neurosurgeryIvumela ama-Pituitary Tumors aphathwe ngendlela enokuhlasela okuncane kweTransnasal Transpheloaliaval ngaphandle kwesidingo se-craniotomy, anciphise izinga lokushona kuka-4.7% ukusuka ku-0,7%. Ukufezekiswa kwale miphumela akunakwenzeka ngaphansi kokuhlinzwa kwamehlo kwendabuko, ngakhoImicrosCasosziwuphawu lwe-neurosurgery yanamuhla futhi ziye zaba ngomunye wemishini yokuhlinza ebaluleke kakhulu futhi engenakufinyeleleka e-Neurosurgery yanamuhla.