ʻO ka mōʻaukala noi a me ke kuleana o nā microscope ʻokiʻoki i ka neurosurgery

 

Ma ka mōʻaukala o ke neurosurgery, ka hoʻohana ʻana onā microscope ʻoki kinohe hōʻailona honua, e holomua ana mai ka wā neurosurgical kuʻuna o ka hana ʻoki kino ma lalo o ka maka ʻōlohelohe i ka wā neurosurgical hou o ka hana ʻoki kino ma lalo o kahimicroscopeʻO wai a i ka manawa hea i hana ainā microscope hanahoʻomaka e hoʻohana ʻia i ka neurosurgery? He aha ke kuleana i loaʻamicroscope ʻoki kinoi pāʻani ʻia i ka hoʻomohala ʻana o ke neurosurgery? Me ka holomua o ka ʻepekema a me ka ʻenehana, eʻO ka microscope hanae pani ʻia e kekahi mau lako hana holomua? He nīnau kēia e pono i kēlā me kēia neurosurgeon ke makaʻala a hoʻopili i ka ʻenehana a me nā mea hana hou loa i ke kahua o ka neurosurgery, e paipai ana i ka hoʻomaikaʻi ʻana i nā mākau ʻoki neurosurgery.

1, Ka Moolelo o nā Hoʻohana Microscopy ma ke Kahua Lapaʻau

I ke ʻano physics, ʻo nā aniani maka he mau aniani convex me kahi ʻano hoʻokahi i loaʻa ka hopena hoʻonui, a ua kaupalena ʻia ko lākou hoʻonui ʻana, i ʻike ʻia he mau aniani hoʻonui. I ka makahiki 1590, ua hoʻokomo ʻelua mau kānaka Dutch i ʻelua mau papa aniani convex i loko o kahi barela cylindrical lahilahi, a pēlā i hana ai i ka mea hoʻonui ʻōnaehana hui mua o ka honua: ʻo kamicroscopeMa hope iho, ua hoʻomaikaʻi mau ʻia ke ʻano o ka microscope, a ua hoʻonui mau ʻia ka hoʻonui ʻana. I kēlā manawa, ua hoʻohana nui nā kānaka ʻepekema i kēiamicroscope hui pū ʻiae nānā i nā ʻano liʻiliʻi o nā holoholona a me nā mea kanu, e like me ke ʻano o nā cell. Mai ka waena a hiki i ka hopena o ke kenekulia 19, ua hoʻohana mālie ʻia nā aniani hoʻonui a me nā microscope i ke kahua o ka lāʻau lapaʻau. I ka wā mua, ua hoʻohana nā kauka ʻoki i nā aniani hoʻonui ʻano aniani me kahi ʻano lens hoʻokahi i hiki ke kau ʻia ma ke alahaka o ka ihu no ke ʻoki ʻana. I ka makahiki 1876, ua hana ke kauka Kelemania ʻo Saemisch i ke ʻoki "microscopic" mua o ka honua me ka hoʻohana ʻana i ke aniani hoʻonui aniani hui (ʻaʻole ʻike ʻia ke ʻano o ke ʻoki ʻana). I ka makahiki 1893, ua hana ka hui Kelemania ʻo Zeiss i kamicroscope binocular, i hoʻohana nui ʻia no ka nānā ʻana i nā hoʻokolohua ma nā keʻena lapaʻau, a no ka nānā ʻana i nā ʻeha corneal a me ke keʻena mua ma ke kahua o ka ophthalmology. I ka makahiki 1921, ma muli o ka noiʻi hale hana ma ke anatomy pepeiao o loko o nā holoholona, ​​ua hoʻohana ka otolaryngologist Suedena ʻo Nylen i kahi paʻamicroscope ʻoki kino monoculari hoʻolālā ʻia a hana ʻia e ia iho e hana i ke ʻoki ʻana i ka otitis media mau loa ma luna o ke kanaka, he microsurgery maoli nō ia. I hoʻokahi makahiki ma hope mai, ua hoʻolauna ke kauka ʻoi loa o Nylen ʻo Hlolmgren i kahimicroscope ʻoki kino binoculari hana ʻia e Zeiss i loko o ka lumi hana.

ʻO ke kakahiaka nuiNā microscope hanahe nui nā hemahema, e like me ke kūpaʻa mechanical maikaʻi ʻole, hiki ʻole ke neʻe, ka hoʻomālamalama ʻana o nā koʻi like ʻole a me ka hoʻomehana ʻana o ka lens objective, ke kahua hoʻonui ʻoki kino haiki, a pēlā aku. ʻO kēia nā kumu āpau e kaupalena ana i ka hoʻohana ākea onā microscope ʻoki kinoI nā makahiki he kanakolu ma hope mai, ma muli o ka launa pū maikaʻi ma waena o nā kauka ʻokiʻoki a menā mea hana microscope, ka hana anā microscope ʻoki kinoua hoʻomaikaʻi mau ʻia, anā microscope ʻoki kino binocular, nā microscope i kau ʻia ma luna o ka hale, nā aniani zoom, ke kukui kumu coaxial, nā lima articulated i kāohi ʻia e ke kaomi uila a i ʻole ka wai, ka hoʻokele pedal wāwae, a pēlā aku i hoʻomohala mau ʻia. I ka makahiki 1953, ua hana ka hui Kelemania ʻo Zeiss i kahi moʻo o nā mea kūikawānā microscope ʻoki kino no ka otology, kūpono loa no nā ʻoki ʻana ma nā ʻeha hohonu e like me ka pepeiao waena a me ka iwi temporal. ʻOiai ka hana onā microscope ʻoki kinoke hoʻomau nei ka holomua, ke loli mau nei ka noʻonoʻo o nā kauka ʻokiʻoki. No ka laʻana, ua ʻōlelo nā kauka Kelemania ʻo Zollner lāua ʻo Wullsteinnā microscope ʻoki kinopono e hoʻohana ʻia no ke ʻoki ʻana i ka membrane tympanic. Mai ka makahiki 1950, ua hoʻololi mālie nā ophthalmologists i ka hana o ka hoʻohana ʻana i nā microscopes wale nō no nā hoʻokolokolo ophthalmic a hoʻolaunanā microscope otosurgicali loko o ke ʻoki maka. Mai ia manawa,ʻO ka microscope hanaUa hoʻohana nui ʻia ma nā wahi o ka ophthalmology a me ka ophthalmology.

2. Hoʻohana ʻia ka microscope ʻoki kino i ka neurosurgery

Ma muli o ke ʻano kūikawā o ka neurosurgery, ʻo ka hoʻohana ʻana onā microscope ʻoki kino i loko o ka neurosurgeryua emi iki ma mua o ka otology a me ka ophthalmology, a ke aʻo ikaika nei nā neurosurgeons i kēia ʻenehana hou. I kēlā manawa, ʻo kaka hoʻohana ʻana i nā microscope ʻoki kinoua nui ma ʻEulopa. Ua hoʻolauna mua ke kauka maka ʻAmelika ʻo Perritnā microscope ʻoki kinomai ʻEulopa a i ʻAmelika Hui Pū ʻIa i ka makahiki 1946, e kau ana i ke kahua no nā neurosurgeons ʻAmelika e hoʻohanaNā microscope hana.

Mai ka manaʻo o ka mahalo ʻana i ka waiwai o ke ola kanaka, pono e hana ʻia nā ʻenehana hou, nā lako, a i ʻole nā ​​mea hana i hoʻohana ʻia no ke kino kanaka i nā hoʻokolohua holoholona mua a me ke aʻo loea no nā mea hoʻohana. I ka makahiki 1955, ua hana ʻo Malis, ke kauka ʻepekema ʻAmelika, i ke ʻoki lolo ma nā holoholona me ka hoʻohana ʻana i kahimicroscope ʻoki kino binocularʻO Kurze, he neurosurgeon ma ke Kulanui o Kaleponi Hema ma ʻAmelika Hui Pū ʻIa, ua hoʻolilo ʻo ia i hoʻokahi makahiki e aʻo ana i nā ʻano hana ʻokiʻoki o ka hoʻohana ʻana i kahi microscope ma ka hale hana ma hope o ka nānā ʻana i ke ʻoki pepeiao ma lalo o kahi microscope. I ʻAukake 1957, ua hoʻokō pono ʻo ia i kahi ʻoki neuroma acoustic ma kahi keiki 5 makahiki me ka hoʻohana ʻana i kahimicroscope ʻoki pepeiao, ʻo ia ke ʻoki kino microsurgical mua loa o ka honua. Ma hope koke iho, ua hoʻokō pono ʻo Kurze i kahi anastomosis aʻalolo sublingual o ke aʻalolo maka ma ke keiki me ka hoʻohana ʻana i kahimicroscope ʻoki kino, a ua maikaʻi loa ka hoʻōla ʻana o ke keiki. ʻO kēia ka lua o ke ʻoki kino microsurgical ma ka honua. Ma hope iho, ua hoʻohana ʻo Kurze i nā kalaka e laweNā microscope hanai nā wahi like ʻole no ka neurosurgery microsurgical, a ua paipai ikaika i ka hoʻohana ʻana onā microscope ʻoki kinoi nā neurosurgeons ʻē aʻe. Ma hope iho, ua hana ʻo Kurze i ke ʻoki ʻoki ʻana o ka aneurysm cerebral me ka hoʻohana ʻana i kahimicroscope ʻoki kino(ʻo ka mea pōʻino, ʻaʻole ʻo ia i paʻi i kekahi mau ʻatikala). Me ke kākoʻo o kahi maʻi neuralgia trigeminal āna i mālama ai, ua hoʻokumu ʻo ia i ka hale hana neurosurgery kumu micro skull mua loa o ka honua i ka makahiki 1961. Pono mākou e hoʻomanaʻo mau i ka hāʻawi ʻana a Kurze i ka microsurgery a aʻo mai kona wiwo ʻole e ʻae i nā ʻenehana a me nā manaʻo hou. Eia naʻe, a hiki i ka hoʻomaka ʻana o nā makahiki 1990, ʻaʻole i ʻae kekahi mau neurosurgeons ma Kina.Nā microscope neurosurgeryno ke ʻoki kino. ʻAʻole kēia he pilikia me kaʻO ka microscope neurosurgeryia iho, akā he pilikia me ka ʻike ideological o nā neurosurgeons.

I ka makahiki 1958, ua hoʻokumu ke kauka ʻepekema ʻAmelika ʻo Donaghy i ka hale hana noiʻi a me ke aʻo ʻana o ka microsurgery mua loa o ka honua ma Burlington, Vermont. I nā wā mua, ua hālāwai pū ʻo ia me ka huikau a me nā pilikia kālā mai kona mau luna. Ma ke kula nui, ua noʻonoʻo mau ʻo ia i ka ʻoki ʻana i nā kīʻaha koko cortical e wehe pololei i ka thrombi mai nā maʻi me ka thrombosis cerebral. No laila ua hui pū ʻo ia me ke kauka ʻoki koko ʻo Jacobson ma ka noiʻi holoholona a me ke lapaʻau. I kēlā manawa, ma lalo o nā kūlana o ka maka ʻōlohelohe, hiki ke humuhumu ʻia nā kīʻaha koko liʻiliʻi me ke anawaena o 7-8 millimeters a ʻoi aku paha. I mea e hoʻokō ai i ka anastomosis end-to-end o nā kīʻaha koko maikaʻi, ua hoʻāʻo mua ʻo Jacobson e hoʻohana i ke aniani hoʻonui ʻano aniani. Ma hope koke iho, ua hoʻomanaʻo ʻo ia i ka hoʻohana ʻana i kahimicroscope ʻoki kino otolaryngologyno ke ʻoki kino i kona wā he kauka noho. No laila, me ke kōkua o Zeiss ma Kelemania, ua hoʻolālā ʻo Jacobson i kahi microscope ʻoki kino pālua (Diploscope) no ka anastomosis vascular, kahi e hiki ai i ʻelua mau kauka ʻoki ke hana i ke ʻoki i ka manawa like. Ma hope o nā hoʻokolohua holoholona nui, ua paʻi ʻo Jacobson i kahi ʻatikala ma ka anastomosis microsurgical o nā ʻīlio a me nā ʻaʻa ʻole carotid (1960), me ka 100% patency rate o ka anastomosis vascular. He pepa lapaʻau groundbreaking kēia e pili ana i ka neurosurgery microsurgical a me ke ʻoki ʻana vascular. Ua hoʻolālā pū ʻo Jacobson i nā mea hana microsurgical he nui, e like me nā micro scissors, nā mea paʻa nila micro, a me nā lima mea hana micro. I ka makahiki 1960, ua hoʻokō pono ʻo Donaghy i kahi thrombectomy incision artery cerebral ma lalo o kahimicroscope ʻoki kinono kahi mea maʻi me ka thrombosis cerebral. Ua hoʻomaka ʻo Rhoton mai ʻAmelika Hui Pū ʻIa e aʻo i ka anatomy o ka lolo ma lalo o kahi microscope i ka makahiki 1967, e paionia ana i kahi kahua hou o ka anatomy microsurgical a me ka hāʻawi ʻana i nā haʻawina koʻikoʻi i ka hoʻomohala ʻana o ka microsurgery. Ma muli o nā pono onā microscope ʻoki kinoa me ka hoʻomaikaʻi ʻana o nā mea hana microsurgical, makemake nui nā kauka ʻokiʻoki e hoʻohananā microscope ʻoki kinono ke ʻoki kino. A ua paʻi i nā ʻatikala pili he nui e pili ana i nā kaʻina hana microsurgical.

3, Hoʻohana ʻia ka microscope ʻoki kino i ka neurosurgery ma Kina

Ma ke ʻano he Kina ma waho aloha ʻāina ma Iapana, ua hāʻawi ʻo Polofesa Du Ziwei i ka makana kūloko muamicroscope ʻokiʻoki loloa me nā mea pilinā mea hana microsurgicali ka ʻOihana Neurosurgery o ka Halemai Affiliated o ke Kulanui Lapaʻau ʻo Suzhou (i kēia manawa ʻo ka ʻOihana Neurosurgery o ka Halemai Mua Affiliated o ke Kulanui ʻo Suzhou) i ka makahiki 1972. Ma hope o kona hoʻi ʻana i Kina, ua hana mua ʻo ia i nā ʻoki kino microsurgical e like me nā aneurysms intracranial a me nā meningiomas. Ma hope o ke aʻo ʻana e pili ana i ka loaʻa ʻana onā microscope neurosurgicala me nā mea hana microsurgical, ua kipa aku ʻo Polofesa Zhao Yadu mai ka ʻOihana Neurosurgery o ka Halemai ʻo Beijing Yiwu iā Polofesa Du Ziwei mai ke Kulanui Lapaʻau ʻo Suzhou e nānā i ka hoʻohana ʻananā microscope ʻoki kinoUa kipa pilikino aku ʻo Polopeka Shi Yuquan mai ka Halemai ʻo Shanghai Huashan i ka ʻoihana o Polopeka Du Ziwei e nānā i nā kaʻina hana microsurgical. ʻO ka hopena, ua nui ka hoʻolauna ʻana, ke aʻo ʻana, a me ka hoʻopili ʻana oNā microscope neurosurgeryua hoʻāla ʻia ma nā kikowaena neurosurgery nui ma Kina, e hōʻailona ana i ka hoʻomaka ʻana o ka micro neurosurgery o Kina.

4. Ka hopena o ke ʻoki kino Microsurgery

Ma muli o ka hoʻohana ʻana onā microscope neurosurgical, hiki ke hana ʻia nā ʻoki ʻana i hiki ʻole ke hana ʻia me ka maka ʻōlohelohe ma lalo o nā kūlana o ka hoʻonui ʻana o 6-10 mau manawa. No ka laʻana, ʻo ka hana ʻana i ke ʻoki ʻana i ka puʻupuʻu pituitary ma o ka sinus ethmoidal hiki ke ʻike palekana a wehe i nā puʻupuʻu pituitary me ka pale ʻana i ka pituitary gland maʻamau; ʻO ke ʻoki ʻana i hiki ʻole ke hana ʻia me ka maka ʻōlohelohe hiki ke lilo i mau ʻoki ʻoi aku ka maikaʻi, e like me nā puʻupuʻu brainstem a me nā puʻupuʻu intramedullary spinal cord. Ua loaʻa i ka Academician Wang Zhongcheng ka nui o ka make ʻana o 10.7% no ke ʻoki ʻana i ka aneurysm cerebral ma mua o ka hoʻohana ʻana i kahimicroscope ʻokiʻoki loloMa hope o ka hoʻohana ʻana i kahi microscope i ka makahiki 1978, ua emi ka nui o ka make i 3.2%. ʻO ka nui o ka make ʻana o ke ʻoki ʻana i ka maʻi arteriovenous cerebral me ka hoʻohana ʻole ʻana i kahimicroscope ʻoki kinohe 6.2%, a ma hope o 1984, me ka hoʻohana ʻana o kahinā microscope neurosurgery, ua emi ka nui o ka make i 1.6%. ʻO ka hoʻohana ʻana omicroscope ʻokiʻoki loloʻae i nā ʻōpū pituitary e mālama ʻia ma o kahi ala transnasal transsphenoidal minimally invasive me ka ʻole o ka pono no ka craniotomy, e hōʻemi ana i ka nui o ka make ʻana mai ka 4.7% a i ka 0.9%. ʻAʻole hiki ke hoʻokō ʻia kēia mau hopena ma lalo o ke ʻoki maka kuʻuna, no lailanā microscope ʻoki kinohe hōʻailona lākou o ka neurosurgery hou a ua lilo i hoʻokahi o nā lako hana koʻikoʻi a hiki ʻole ke hoʻololi ʻia i ka neurosurgery hou.