Mbiri yakugwiritsa ntchito ndi gawo la maikulosikopu opangira opaleshoni mu neurosurgery

 

M'mbiri ya neurosurgery, kugwiritsa ntchitomicroscopes opaleshonindi chizindikiro chochititsa chidwi kwambiri, kuyambira nthawi yachikhalidwe ya opaleshoni ya minyewa yochitira opaleshoni maso amaliseche kupita ku nthawi yamakono yopangira opaleshoni pansi pamaikulosikopu. Ndani ndipo anachita litimicroscope ntchitokuyamba kugwiritsidwa ntchito mu neurosurgery? Ndi udindo wanjimicroscope opaleshoniadasewera pakukula kwa neurosurgery? Ndi kupita patsogolo kwa sayansi ndi ukadaulo, zithaMaikulosikopu ogwira ntchitokusinthidwa ndi zida zina zapamwamba kwambiri? Ili ndi funso lomwe dokotala aliyense wochita opaleshoni ayenera kudziwa ndikugwiritsa ntchito ukadaulo waposachedwa kwambiri ndi zida pagawo la neurosurgery, kulimbikitsa luso la opaleshoni ya neurosurgery.

1, Mbiri Yogwiritsa Ntchito Microscopy mu Medical Field

Mu fizikisi, magalasi agalasi ndi magalasi owoneka bwino okhala ndi mawonekedwe amodzi omwe amakhala ndi kukulitsa, ndipo kukulitsa kwawo kumakhala kochepa, komwe kumadziwika kuti magalasi okulitsa. Mu 1590, anthu awiri achi Dutch adayika mbale ziwiri za ma lens mkati mwa mbiya yopyapyala, motero adapanga chipangizo choyamba chokulirapo padziko lonse lapansi:maikulosikopu. Pambuyo pake, mapangidwe a microscope adasinthidwa mosalekeza, ndipo kukulitsa kumawonjezeka mosalekeza. Pa nthawiyo, asayansi makamaka ankagwiritsa ntchito izimicroscope yamagulukuona ting’onoting’ono ta nyama ndi zomera, monga mmene maselo amapangidwira. Kuyambira chapakati mpaka kumapeto kwa zaka za m'ma 1800, magalasi okulirapo ndi maikulosikopu akhala akugwiritsidwa ntchito pang'onopang'ono pazamankhwala. Poyamba, madokotala ochita opaleshoni ankagwiritsa ntchito magalasi okulira m’magalasi okhala ndi lens imodzi yokha yomwe ankatha kuwaika pa mlatho wa mphuno kuti achite opaleshoni. Mu 1876, dokotala wa ku Germany Saemisch anachita opaleshoni yoyamba ya "microscopic" padziko lonse lapansi pogwiritsa ntchito galasi lokulitsa maso (mtundu wa opaleshoni sudziwika). Mu 1893, kampani ya ku Germany ya Zeiss inatulukiramicroscope, yomwe imagwiritsidwa ntchito makamaka poyesa kuyesa m'ma laboratories azachipatala, komanso kuyang'ana zilonda zam'chipinda zam'chipinda cham'mbuyo ndi zapakhomo m'munda wa ophthalmology. Mu 1921, kutengera kafukufuku wa labotale wokhudza makutu amkati mwa nyama, katswiri wa otolaryngologist wa ku Sweden Nylen adagwiritsa ntchito njira yokhazikika.microscope ya opaleshoni ya monocularkupangidwa ndi kupangidwa ndi iyemwini kuti achite opaleshoni ya otitis media kwa anthu, yomwe inali microsurgery yeniyeni. Patatha chaka chimodzi, dokotala wamkulu wa Nylen, Hlolmgren, adayambitsa amicroscope ya opaleshoni yamabinocularopangidwa ndi Zeiss mu chipinda cha opaleshoni.

The oyambiriraMaikulosikopu ogwira ntchitoanali ndi zovuta zambiri, monga kusakhazikika kwa makina, kulephera kusuntha, kuwunikira kwa nkhwangwa zosiyanasiyana ndi kutentha kwa lens, malo okulitsa maopaleshoni, ndi zina zotero. Izi ndi zifukwa zonse zomwe zimalepheretsa kugwiritsa ntchito kwambirimicroscopes opaleshoni. M'zaka makumi atatu zotsatira, chifukwa cha mgwirizano wabwino pakati pa madokotala ndiopanga maikulosikopu, machitidwe amicroscopes opaleshoniidasinthidwa mosalekeza, ndima microscopes opangira ma binocular, padenga wokwera microscopes, ma zoom lens, coaxial light source kuunikira, magetsi kapena mphamvu yamadzi yoyendetsedwa ndi manja, kuwongolera phazi, ndi zina zotero zinapangidwa motsatizana. Mu 1953, kampani ya ku Germany Zeiss inapanga mndandanda wa akatswirimicroscopes opaleshoni kwa otology, makamaka oyenera maopaleshoni a zilonda zakuya monga khutu lapakati ndi fupa la temporal. Pamene ntchito yamicroscopes opaleshoniakupitirizabe kusintha, maganizo a madokotala ochita opaleshoni amasintha nthawi zonse. Mwachitsanzo, madokotala a ku Germany Zollner ndi Wullstein ananena zimenezomicroscopes opaleshoniAyenera kugwiritsidwa ntchito popanga opaleshoni ya tympanic membrane. Kuyambira m’ma 1950, akatswiri a maso asintha pang’onopang’ono mchitidwe wogwiritsa ntchito maikulosikopu pofufuza maso ndi kuyambitsa.microscopes ya otosurgicalku opaleshoni ya ophthalmic. Kuyambira pamenepo,Maikulosikopu ogwira ntchitoZakhala zikugwiritsidwa ntchito kwambiri m'magawo a otology ndi ophthalmology.

2, Kugwiritsa ntchito maikulosikopu opangira opaleshoni mu neurosurgery

Chifukwa cha kukhazikika kwa ma neurosurgery, kugwiritsa ntchito kwamicroscopes opaleshoni mu neurosurgeryyachedwa pang'ono kusiyana ndi otology ndi ophthalmology, ndipo madokotala ochita opaleshoni akuphunzira mwakhama luso latsopanoli. Pa nthawiyo, akugwiritsa ntchito maikulosikopu opangira opaleshonianali makamaka ku Ulaya. Katswiri wa ophthalmologist waku America Perrit adadziwika koyambamicroscopes opaleshonikuchokera ku Europe kupita ku United States mu 1946, ndikuyika maziko a ma neurosurgeon aku America kuti agwiritse ntchitoMaikulosikopu ogwira ntchito.

Polemekeza kufunika kwa moyo wa munthu, umisiri watsopano uliwonse, zida, kapena zida zomwe zimagwiritsidwa ntchito pathupi la munthu ziyenera kuyesedwa koyambirira kwa nyama ndi maphunziro aukadaulo kwa ogwira ntchito. Mu 1955, dokotala wa opaleshoni ya ubongo wa ku America Malis anachita opaleshoni ya ubongo pa zinyama pogwiritsa ntchito amicroscope ya opaleshoni yamabinocular. Kurze, dokotala wa opaleshoni ya minyewa wa pa yunivesite ya Southern California ku United States, anatha chaka chimodzi akuphunzira njira zopangira opaleshoni pogwiritsa ntchito makina oonera zinthu zing’onozing’ono mu labotale ataona opaleshoni yamakutu pogwiritsa ntchito maikulosikopu. Mu Ogasiti 1957, adachita bwino opaleshoni ya acoustic neuroma pa mwana wazaka zisanumicroscope ya opaleshoni yamakutu, amene anali opaleshoni yoyamba padziko lonse ya opaleshoni yaing’ono. Posakhalitsa, Kurze anachita bwinobwino nkhope ya mitsempha sublingual mitsempha anastomosis pa mwanayo ntchitomicroscope opaleshoni, ndipo kuchira kwa mwanayo kunali kwabwino kwambiri. Iyi inali opaleshoni yachiwiri padziko lonse lapansi. Pambuyo pake, Kurze ananyamula magalimotoMaikulosikopu ogwira ntchitoku malo osiyanasiyana kwa microsurgical neurosurgery, ndipo analimbikitsa kwambiri kugwiritsa ntchitomicroscopes opaleshonikwa ma neurosurgeon ena. Pambuyo pake, Kurze anachita opaleshoni yodula ubongo pogwiritsa ntchito amicroscope opaleshoni(mwatsoka, sanasindikize zolemba zilizonse). Mothandizidwa ndi trigeminal neuralgia wodwala yemwe adamuchiritsa, adakhazikitsa labotale yoyamba yapadziko lonse lapansi ya micro skull base neurosurgery mu 1961. Tiyenera kukumbukira nthawi zonse zomwe Kurze adathandizira ku microsurgery ndikuphunzira kuchokera ku kulimba mtima kwake kuvomereza matekinoloje atsopano ndi malingaliro. Komabe, mpaka kumayambiriro kwa zaka za m’ma 1990, madokotala ena ochita opaleshoni ya ubongo ku China sanavomerezeMa microscopes a Neurosurgeryza opaleshoni. Ili silinali vuto ndiNeurosurgery microscopelokha, koma vuto ndi kumvetsetsa kwamalingaliro a neurosurgeons.

Mu 1958, donaghy waku America yemwe ndi dokotala wochita opaleshoni ya neurosurgery adakhazikitsa labotale yoyamba padziko lonse lapansi yofufuza ndi kuphunzitsa ku Burlington, Vermont. Kumayambiriro, adakumananso ndi chisokonezo ndi mavuto azachuma kuchokera kwa akuluakulu ake. Mu maphunziro, iye nthawizonse ankaona kudula lotseguka cortical mitsempha mwachindunji kuchotsa thrombi kwa odwala thrombosis ubongo. Chifukwa chake adagwirizana ndi dokotala wa opaleshoni ya mitsempha Jacobson pa kafukufuku wa nyama ndi zamankhwala. Panthawiyo, pansi pa zikhalidwe za maso, mitsempha yaing'ono yamagazi yokhala ndi mamilimita 7-8 kapena kuposerapo ikanatha. Kuti akwaniritse ma anastomosis a mitsempha yabwino kwambiri yamagazi, Jacobson adayamba kuyesa kugwiritsa ntchito galasi lokulitsa la magalasi. Posakhalitsa, adakumbukira kugwiritsa ntchitootolaryngology opaleshoni microscopekwa opaleshoni pamene anali dokotala wokhalamo. Chifukwa chake, mothandizidwa ndi Zeiss ku Germany, Jacobson adapanga maikolofoni yopangira opaleshoni yapawiri.Diploscope) kwa vascular anastomosis, yomwe imalola madokotala awiri opaleshoni kuchita opaleshoni imodzi. Pambuyo poyesa nyama zambiri, Jacobson adasindikiza nkhani yokhudza microsurgical anastomosis ya agalu ndi mitsempha yopanda carotid (1960), yokhala ndi 100% patency rate of vascular anastomosis. Ichi ndi pepala lachipatala lomwe limagwirizana ndi microsurgical neurosurgery ndi opaleshoni ya mitsempha. Jacobson adapanganso zida zambiri zopangira ma microsurgical, monga masikelo ang'onoang'ono, zonyamula singano zazing'ono, ndi zogwirira ntchito zazing'ono. Mu 1960, Donaghy adachita bwino opaleshoni ya cerebral artery incision thrombectomy.microscope opaleshonikwa odwala omwe ali ndi cerebral thrombosis. Rhoton wa ku United States anayamba kuphunzira mmene anatomi a ubongo amachitira pogwiritsa ntchito maikulosikopu mu 1967. Chifukwa cha ubwino wamicroscopes opaleshonikomanso kukonza zida zopangira opaleshoni, madokotala ambiri amakonda kugwiritsa ntchitomicroscopes opaleshoniza opaleshoni. Ndipo adafalitsa nkhani zambiri zokhudzana ndi njira za microsurgical.

3, Kugwiritsa ntchito maikulosikopu opangira opaleshoni mu neurosurgery ku China

Monga munthu wokonda dziko la China ku Japan ku Japan, Pulofesa Du Ziwei anapereka ndalama zoyamba zapakhomomicroscope ya neurosurgicalndi zokhudzanazida za microsurgicalku Dipatimenti ya Neurosurgery ya Suzhou Medical College Affiliated Hospital (yomwe tsopano ndi Dipatimenti ya Neurosurgery ya Suzhou University Affiliated First Hospital) mu 1972. Atabwerera ku China, anayamba kuchita maopaleshoni aang'ono monga intracranial aneurysms ndi meningiomas. Pambuyo pophunzira za kupezeka kwama microscopes a neurosurgicalndi zida zopangira ma microsurgery, Pulofesa Zhao Yadu wa ku dipatimenti ya Neurosurgery ku chipatala cha Beijing Yiwu adayendera Pulofesa Du Ziwei waku Suzhou Medical College kuti akawone kugwiritsa ntchitomicroscopes opaleshoni. Pulofesa Shi Yuquan waku chipatala cha Shanghai Huashan adayendera dipatimenti ya Pulofesa Du Ziwei kuti akawone momwe ma opaleshoni amathandizira. Zotsatira zake, funde lachiyambi, kuphunzira, ndi kugwiritsa ntchitoMa microscopes a Neurosurgeryidayambika m'malo akuluakulu a neurosurgery ku China, zomwe zikuwonetsa chiyambi cha China cha microsurgery.

4, Zotsatira za Opaleshoni ya Microsurgery

Chifukwa chogwiritsa ntchitoma microscopes a neurosurgical, maopaleshoni omwe sangathe kuchitidwa ndi maso amakhala otheka pansi pa kukulitsa nthawi 6-10. Mwachitsanzo, kuchita opaleshoni ya chotupa cha pituitary kudzera m'mphuno ya ethmoidal kungadziwe bwino ndikuchotsa zotupa za pituitary ndikuteteza gland yabwinobwino; Maopaleshoni omwe sangathe kuchitidwa ndi maso amatha kukhala maopaleshoni abwinoko, monga zotupa za muubongo ndi zotupa za msana wa intramedullary. Katswiri Wamaphunziro Wang Zhongcheng anali ndi chiwopsezo cha kufa kwa 10.7% pa opareshoni yaubongo ya aneurysm asanagwiritse ntchitomicroscope ya neurosurgery. Atatha kugwiritsa ntchito microscope mu 1978, chiwerengero cha anthu omwe amafa chinatsika mpaka 3.2%. Chiwopsezo cha kufa kwa opareshoni ya cerebral arteriovenous malformation popanda kugwiritsa ntchito amicroscope opaleshonianali 6.2%, ndipo pambuyo pa 1984, pogwiritsa ntchito ama microscopes a neurosurgery, chiŵerengero cha imfa chinatsika kufika pa 1.6%. Kugwiritsa ntchitomicroscope ya neurosurgeryzimathandiza kuti zotupa za pituitary zichirikidwe kudzera mu njira yochepetsetsa ya transnasal transsphenoidal popanda kufunikira kwa craniotomy, kuchepetsa chiwerengero cha imfa za opaleshoni kuchoka pa 4.7% kufika pa 0.9%. Kupindula kwa zotsatirazi sikutheka pansi pa opaleshoni yamaso yachikhalidwe, chonchomicroscopes opaleshonindi chizindikiro cha ma neurosurgery amakono ndipo akhala chimodzi mwazinthu zofunika kwambiri komanso zosasinthika mu ma neurosurgery amakono.