ʻO ka mōʻaukala noi a me ke kuleana o nā microscopes surgical i ka neurosurgery

 

I ka moʻolelo o ka neurosurgery, ka noi omicroscopes hanaHe hōʻailona hōʻailona ia, e neʻe ana mai ka wā neurosurgical kuʻuna o ka hana ʻana ma lalo o ka maka ʻōlohelohe a hiki i ke au neurosurgical hou o ka hana ʻana ma lalo o kahi.microscope. ʻO wai a i ka manawa hea i hana aimicroscopes hanahoʻomaka e hoʻohana i ka neurosurgery? He aha ke kuleanamicroscope ʻokiʻokipāʻani i ka hoʻomohala ʻana i ka neurosurgery? Me ka holomua o ka ʻepekema a me ka ʻenehana, emicroscope hanae pani ʻia e kekahi mau lako ʻoi aku ka holomua? He nīnau kēia e ʻike pono ai kēlā me kēia neurosurgeon a hoʻohana i ka ʻenehana a me nā mea hana hou loa i ke kahua o ka neurosurgery, e hāpai ana i ka hoʻomaikaʻi ʻana i nā mākau hoʻokele neurosurgery.

1、Ka Moʻolelo o nā noi Microscopy ma ke kahua Lapaʻau

Ma ka physics, he mau lens convex nā maka aniani me ka hale hoʻokahi i loaʻa ka hopena hoʻonui, a ua kaupalena ʻia ko lākou hoʻonui ʻana, i kapa ʻia ʻo nā aniani hoʻonui. I ka makahiki 1590, ua hoʻokomo ʻelua poʻe Dutch i ʻelua mau papa lens convex i loko o kahi pahu cylindrical slender, no laila ua haku ʻia ka mea hana hoʻonui mua o ka honua: kamicroscope. Ma hope, ua hoʻomaikaʻi mau ʻia ke ʻano o ka microscope, a ua hoʻonui mau ʻia ka hoʻonui. I kēlā manawa, hoʻohana nui nā ʻepekema i kēiamicroscope compositee nānā i nā hale liʻiliʻi o nā holoholona a me nā mea kanu, e like me ke ʻano o nā cell. Mai ka waenakonu o ke kenekulia 19, ua hoʻohana mālie ʻia nā aniani hoʻonui a me nā microscopes i ka lāʻau lapaʻau. I ka wā mua, ua hoʻohana nā kauka lapaʻau i nā makaaniani hoʻonui i ke ʻano aniani me kahi ʻano lens hoʻokahi i hiki ke kau ʻia ma ke alahaka o ka ihu no ke ʻoki. I ka makahiki 1876, ua hana ke kauka Kelemania Saemisch i ke oki "microscopic" mua loa o ka honua me ka hoohana ana i ke aniani makaaniani hoonui (ʻaʻole ʻike ʻia ke ʻano o ka ʻoki). I ka makahiki 1893, ua hana ka hui Kelemania Zeiss i kaʻo ke kiʻi microscope binocular, Hoʻohana nui ʻia no ka nānā ʻana i ka hoʻokolohua ma nā keʻena lapaʻau, a me ka nānā ʻana i nā ʻeha o ka corneal a me ke keʻena mua ma ke kahua o ka ophthalmology. I ka makahiki 1921, ma muli o ka noiʻi ʻana o ka ʻimi noiʻi e pili ana i ka anatomy pepeiao o loko o nā holoholona, ​​ua hoʻohana ʻo Nylen otolaryngologist Swedish i kahi paʻa.monocular surgical microscopei hoʻolālā ʻia a hana ʻia e ia iho e hana i ke kaʻina otitis media maʻi ma luna o nā kānaka, ʻo ia ka microsurgery maoli. Hoʻokahi makahiki ma hope mai, ua hoʻolauna ke kauka kiʻekiʻe o Nylen ʻo Hlolmgren i kahimicroscope ʻokiʻoki binocularhana ʻia e Zeiss i loko o ka lumi hana.

ʻO ke kakahiakaNā microscopes hanahe nui nā hemahema, e like me ka paʻa ʻole o ka mechanical, hiki ʻole ke neʻe, ka hoʻomālamalama ʻana o nā koʻi like ʻole a me ka hoʻomehana ʻana o ka lens pahuhopu, ke kahua hoʻonui ʻokiʻoki haiki, a me nā mea ʻē aʻe.microscopes hana. I nā makahiki he kanakolu e hiki mai ana, ma muli o ka pilina maikaʻi ma waena o nā kauka lapaʻau a memea hana microscope, ka hana ana omicroscopes hanaua hoʻomaikaʻi mau ʻia, amicroscopes ʻokiʻoki binocular, microscopes kau i ka hale, nā lens zoom, hoʻomālamalama kumu kukui coaxial, uila uila a i ʻole kaomi wai i hoʻopaʻa ʻia i nā lima articulated, mana wāwae wāwae, a pēlā aku. I ka makahiki 1953, ua hana ka hui Kelemania ʻo Zeiss i kahi ʻano loeamicroscopes ʻokiʻoki no ka otology, kūpono loa no ka ʻoki ʻana i nā ʻeha hohonu e like me ka pepeiao waena a me ka iwi kino. ʻOiai ka hana ʻana omicroscopes hanaKe hoʻomau nei ka hoʻomaikaʻi ʻana, ke loli mau nei ka noʻonoʻo o nā kauka. No ka laʻana, ua ʻōlelo nā kauka Kelemania ʻo Zollner lāua ʻo Wullstein i kēlāmicroscopes hanaPono e hoʻohana ʻia no ka hana ʻana o ka membrane tympanic. Mai ka makahiki 1950, ua hoʻololi mālie ka poʻe ophthalmologists i ka hana o ka hoʻohana ʻana i nā microscopes no nā hoʻokolohua ophthalmic a hoʻokomo ʻia.microscopes otosurgicali loko o ka ophthalmic oki. Mai ia manawa,microscope hanaUa hoʻohana nui ʻia i ka otology a me ka ophthalmology.

2、Ka noi ʻana o ka microscope ʻokiʻoki i ka neurosurgery

Ma muli o ke ʻano o ka neurosurgery, ka hoʻohana ʻana onā microscopes ʻokiʻoki i ka neurosurgeryʻoi aku ka liʻiliʻi ma mua o ka otology a me ka ophthalmology, a ke aʻo ikaika nei nā neurosurgeons i kēia ʻenehana hou. I kēlā manawa, kaka hoʻohana ʻana i nā microscopes hanaaia ma ʻEulopa. Ua hoʻolauna mua ʻia ʻo Perrit ophthalmologist ʻAmelikamicroscopes hanamai ʻEulopa a i ʻAmelika Hui Pū ʻIa i ka makahiki 1946, e kau ana i ke kahua no nā neurosurgeons ʻAmelika e hoʻohana aiNā microscopes hana.

Mai ka manaʻo e pili ana i ka waiwai o ke ola kanaka, pono nā ʻenehana hou, nā mea hana a i ʻole nā ​​​​mea hana i hoʻohana ʻia no ke kino o ke kanaka e hana mua i nā hoʻokolohua holoholona a me ka hoʻomaʻamaʻa ʻenehana no nā mea hana. I ka makahiki 1955, ua hana ʻo Malis neurosurgeon ʻAmelika i ke ʻoki lolo i nā holoholona me ka hoʻohana ʻana i kahimicroscope ʻokiʻoki binocular. Ua hoʻohana ʻo Kurze, he neurosurgeon ma ke Kulanui o Kaleponi Hema ma ʻAmelika Hui Pū ʻIa, i hoʻokahi makahiki e aʻo i nā ʻano hana o ka hoʻohana ʻana i kahi microscope i loko o ka hale hana ma hope o ka nānā ʻana i ke ʻoki pepeiao ma lalo o kahi microscope. I ʻAukake i ka makahiki 1957, ua hana maikaʻi ʻo ia i kahi ʻoki neuroma acoustic ma kahi keiki 5 makahiki me ka hoʻohana ʻana i kahimicroscope oki pepeiao, ʻo ia ke ʻoki ʻoki ʻoki kino mua loa o ka honua. Ma hope koke iho, ua hoʻokō maikaʻi ʻo Kurze i kahi anastomosis nerve sublingual facial ma ke keiki me ka hoʻohana ʻana i kahimicroscope ʻokiʻoki, a ua maikaʻi ke ola o ke keiki. ʻO kēia ka lua o ka ʻokiʻoki microsurgical ma ka honua. Ma hope, ua hoʻohana ʻo Kurze i nā kaʻa e laweNā microscopes hanai nā wahi like ʻole no ka microsurgical neurosurgery, a paipai ikaika i ka hoʻohana ʻanamicroscopes hanai nā neurosurgeon ʻē aʻe. Ma hope iho, ua hana ʻo Kurze i ka ʻoki ʻoki ʻana i ka cerebral aneurysm me ka hoʻohana ʻana i kahimicroscope ʻokiʻoki(akā, ʻaʻole ʻo ia i hoʻopuka i kekahi ʻatikala). Me ke kākoʻo o ka trigeminal neuralgia maʻi āna i mālama ai, ua hoʻokumu ʻo ia i ka honua micro skull base neurosurgery laboratory ma 1961. Pono mākou e hoʻomanaʻo mau i ka hāʻawi ʻana o 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 nā makahiki 1990, ʻaʻole i ʻae kekahi mau neurosurgeons ma KinaNā microscopes neurosurgeryno ke oki. ʻAʻole kēia he pilikia me kaʻO ka microscope neurosurgerypono'ī, akā he pilikia me ka ʻike ideological o nā neurosurgeons.

I ka makahiki 1958, ua hoʻokumu ʻo ʻAmelika neurosurgeon ʻo Donaghy i ka ʻimi noiʻi microsurgery mua a me ka hale hoʻonaʻauao ma Burlington, Vermont. I ka wā mua, ua hui pū ʻo ia i ka huikau a me nā pilikia kālā mai kona mau luna. Ma ke kula, manaʻo mau ʻo ia e ʻoki i nā kīʻaha koko cortical e wehe pololei i ka thrombi mai nā maʻi me ka thrombosis cerebral. No laila ua hana pū ʻo ia me ke kauka lapaʻau vascular Jacobson ma ka noiʻi holoholona a me ke kauka. I kēlā manawa, ma lalo o nā kūlana o ka maka maka, hiki ke hoʻopaʻa ʻia nā kīʻaha koko liʻiliʻi me ke anawaena o 7-8 millimeters a ʻoi aku paha. No ka loaʻa ʻana o ka anastomosis hope-to-end o nā kīʻaha koko ʻoi aku ka maikaʻi, ua hoʻāʻo mua ʻo Jacobson e hoʻohana i ke aniani hoʻonui ʻano aniani. Ma hope koke iho, hoʻomanaʻo ʻo ia i ka hoʻohana ʻana i kahiotolaryngology surgical microscopeno ke oki ana i kona wa he kauka noho. No laila, me ke kōkua o Zeiss ma Kelemānia, ua hoʻolālā ʻo Jacobson i kahi microscope surgical operator ʻelua (Diploscope) no ka anastomosis vascular, ka mea e hiki ai i na kauka lapaau elua ke hana i ke oki i ka manawa hookahi. Ma hope o nā hoʻokolohua holoʻokoʻa holoholona, ​​ua paʻi ʻo Jacobson i kahi ʻatikala e pili ana i ka anastomosis microsurgical o nā ʻīlio a me nā ʻaʻaʻa non carotid (1960), me ka 100% patency rate of vascular anastomosis. He pepa lapaʻau hou kēia e pili ana i ka neurosurgery microsurgical a me ka ʻoki ʻana i nā ʻōpū. Ua hoʻolālā pū ʻo Jacobson i nā mea hana microsurgical he nui, e like me nā ʻokiʻoki liʻiliʻi, nā mea paʻa micro needle, a me nā lima mea kani micro. I ka makahiki 1960, ua hana maikaʻi ʻo Donaghy i kahi thrombectomy o ke aʻaʻa cerebral ma lalo o kahimicroscope ʻokiʻokino ka mea maʻi me ka cerebral thrombosis. Ua hoʻomaka ʻo Rhoton mai ʻAmelika Hui Pū ʻIa i ke aʻo ʻana i ka anatomy lolo ma lalo o kahi microscope i ka makahiki 1967, i paionia i kahi kahua hou o ka microsurgical anatomy a hāʻawi i nā haʻawina nui i ka hoʻomohala ʻana i ka microsurgery. Ma muli o nā pono omicroscopes hanaa me ka hoʻomaikaʻi ʻana i nā mea hana microsurgical, ʻoi aku ka nui o nā kauka lapaʻau e makemake e hoʻohanamicroscopes hanano ke oki. A hoʻopuka i nā ʻatikala e pili ana i nā kaʻina hana microsurgical.

3、Ka hoʻohana ʻana i ka microscope ʻokiʻoki i ka neurosurgery ma Kina

Ma ke ʻano he Pākē aloha ʻāina ma Iapana, ua hāʻawi ʻo Professor Du Ziwei i ka home muamicroscope neurosurgicala pilimea hana microsurgicali ke Keʻena Neurosurgery o Suzhou Medical College Affiliated Hospital (i kēia manawa ʻo ka Neurosurgery Department of Suzhou University Affiliated First Hospital) ma 1972. Ma hope o ka hoʻi ʻana i Kina, ua hana mua ʻo ia i nā hana microsurgical e like me intracranial aneurysms a me meningiomas. Ma hope o ke aʻo ʻana e pili ana i ka loaʻa onā microscopes neurosurgicala me nā mea hana microsurgical, ua kipa aku ʻo Professor Zhao Yadu mai ke Keʻena Neurosurgery o ka Halemai ʻo Beijing Yiwu iā Professor Du Ziwei mai ke Kulanui Lapaʻau ʻo Suzhou e nānā i ka hoʻohana ʻana omicroscopes hana. Ua kipa pilikino ʻo Polofesa Shi Yuquan mai ka Halemai ʻo Shanghai Huashan i ke keʻena ʻo Professor Du Ziwei e nānā i nā kaʻina hana microsurgical. ʻO ka hopena, he nalu o ka hoʻolauna, aʻo ʻana, a me ka hoʻohana ʻana oNā microscopes 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 ka ʻoki ʻana i ka Microsurgery

Ma muli o ka hoʻohana ʻana onā microscopes neurosurgical, ʻO nā ʻokiʻoki ʻaʻole hiki ke hana me ka maka ʻōlohelohe e hiki ke kūpono 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 maʻi maʻi pituitary ma o ka ethmoidal sinus hiki ke hoʻomaopopo pono a wehe i nā ʻōpū pituitary i ka wā e pale ana i ka gland pituitary maʻamau; ʻO ka ʻoki ʻana ʻaʻole hiki ke hana ʻia me ka maka ʻōlohelohe hiki ke lilo i mau hana ʻoi aku ka maikaʻi, e like me nā ʻōpū o ka lolo a me nā ʻōpū intramedullary spinal cord. He 10.7% ka nui o ka make ʻana o ka mea hoʻonaʻauao ʻo Wang Zhongcheng no ka ʻoki ʻana i ka cerebral aneurysm ma mua o ka hoʻohana ʻana.microscope neurosurgery. Ma hope o ka hoʻohana ʻana i kahi microscope i ka makahiki 1978, ua emi ka nui o ka make i 3.2%. Ka nui o ka make o ka cerebral arteriovenous malformation oki me ka hoohana ole amicroscope ʻokiʻokiʻo 6.2%, a ma hope o 1984, me ka hoʻohana ʻana i kahinā microscopes neurosurgery, ua emi ka nui o ka make i ka 1.6%. Ka hoohana ana omicroscope neurosurgeryhiki ke mālama ʻia nā maʻi maʻi pituitary ma o ka transnasal transsphenoidal approach minimally invasive me ka ʻole o ka craniotomy, e hōʻemi ana i ka nui o ka make ma ke kaʻina hana mai 4.7% a i 0.9%. ʻAʻole hiki ke hoʻokō i kēia mau hopena ma lalo o ke ʻoki ʻana o ka maka maʻamau, no lailamicroscopes hanahe hōʻailona o ka neurosurgery hou a ua lilo i hoʻokahi o nā mea hana pono a hiki ʻole ke hoʻololi ʻia i ka neurosurgery hou.