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Imbali yesicelo kunye nendima yeemicroscopes zotyando kwi-neurosurgery

 

Kwimbali ye-neurosurgery, ukusetyenziswa kweimikroskopu yotyandosimboli eyothusayo, ihambela phambili ukusuka kwixesha lotyando lwesiqhelo lokwenziwa utyando phantsi kweliso leze ukuya kwixesha lale mihla le-neurosurgical yokwenza utyando phantsi kotyando.ngemakroskopu. Ngubani kwaye niniiimicroscopes zokusebenzauqalise ukusetyenziswa kwi-neurosurgery? Eyiphi indimaImikroskopu yotyandoidlalwe kuphuhliso lwe-neurosurgery? Ngenkqubela phambili yesayensi kunye neteknoloji, iyaI-microscope yokusebenzaendaweni yezinye izixhobo eziphambili? Lo ngumbuzo ukuba yonke i-neurosurgeon kufuneka iqaphele kwaye isebenzise iteknoloji yakutshanje kunye nezixhobo kwintsimi ye-neurosurgery, ukukhuthaza ukuphuculwa kwezakhono zotyando lwe-neurosurgery.

1, Imbali yezicelo zeMicroscopy kwiNdawo yezoNyango

Kwifiziksi, iilensi zeglasi yamehlo ziilensi zeconvex ezinesakhiwo esinye esinesiphumo sokukhulisa, kwaye ukwandiswa kwazo kulinganiselwe, okwaziwa ngokuba ziiglasi zokukhulisa. Ngo-1590, amaDatshi amabini afakela iipleyiti ezimbini zelensi zeconvex ngaphakathi kumbhobho obhityileyo wecylindrical, ngaloo ndlela beyila isixhobo sokuqala esiyintlanganisela sokukhulisa isakhiwo:ngemakroskopu. Emva koko, ubume be-microscope buphuculwe ngokuqhubekayo, kwaye ukukhulisa kwanda ngokuqhubekayo. Ngelo xesha, izazinzulu zaziyisebenzisa kakhulu le ntoimicroscope edibeneyoukujonga izakhiwo ezincinci zezilwanyana kunye nezityalo, ezifana nokwakheka kweeseli. Ukusukela phakathi ukuya ekupheleni kwenkulungwane ye-19, iiglasi zokukhulisa kunye neemicroscope ziye zasetyenziswa ngokuthe ngcembe kwicandelo lamayeza. Ekuqaleni, oogqirha botyando babesebenzisa iindondo zokukhulisa iglasi yamehlo enesixhobo sokwenza ilensi enye eyayinokubekwa kwibhulorho yempumlo xa kusenziwa utyando. Ngomnyaka we-1876, ugqirha waseJamani u-Saemisch wenza utyando lokuqala lwehlabathi "oluncinci" esebenzisa iglasi yokukhulisa amehlo edibeneyo (uhlobo lotyando alwaziwa). Ngomnyaka we-1893, inkampani yaseJamani iZeiss yenza ii-binocular microscope, ikakhulu isetyenziselwa ukujonga umfuniselo kwiilabhoratri zonyango, kunye nokuqwalaselwa kwezilonda ze-cornea kunye ne-anterior chamber kwintsimi ye-ophthalmology. Ngo-1921, ngokusekwe kuphando lwebhubhoratri kwi-anatomy yendlebe yangaphakathi yesilwanyana, i-otolaryngologist yaseSweden uNylen wasebenzisa i-fixed.Imakroskopu yotyando lwe-monocularyenzelwe kwaye yenziwe nguye ukuba enze utyando olungapheliyo lwe-otitis media kubantu, okwakuyi-microsurgery yokwenene. Emva konyaka, ugqirha ophakamileyo kaNylen uHlolmgren wazisa aimakroskopu yotyando lwebiyinoculareyenziwe nguZeiss kwigumbi lokusebenza.

EkuseniIimicroscopes ezisebenzayobabenezithintelo ezininzi, ezifana nozinzo olulambathayo kumatshini, ukungakwazi ukuhamba, ukukhanya kwee-asi ezahlukeneyo kunye nokufudumeza i-lens yenjongo, ibala elimxinwa lokwandisa utyando, njl.imikroskopu yotyando. Kwiminyaka engamashumi amathathu elandelayo, ngenxa yentsebenziswano entle phakathi koogqirha kunyeabavelisi bemakroskopu, ukusebenza kweimikroskopu yotyandoyaphuculwa ngokuqhubekayo, kwayeimikroskopu yotyando lwebinocular, iimakroskopu ezifakwe eluphahleni, iilensi zokusondeza, ukukhanya komthombo we-coaxial, i-electronic okanye uxinzelelo lwamanzi olulawulwa ziingalo ezichaziweyo, ulawulo lweenyawo ezinyovwayo, njalo njalo zaphuhliswa ngokulandelelanayo. Ngowe-1953, inkampani yaseJamani iZeiss yavelisa uluhlu olukhethekileyoiimicroscopes zotyando kwi-otology, ilungele ngokukodwa utyando kwizilonda ezinzulu ezifana nendlebe ephakathi kunye nethambo lexeshana. Ngelixa ukusebenza kweimikroskopu yotyandoiyaqhubeka iphucuka, ingqondo yoogqirha botyando nayo ihlala itshintsha. Ngokomzekelo, oogqirha baseJamani uZollner noWullstein bakuchaza okoimikroskopu yotyandokufuneka kusetyenziswe utyando lokubumba inwebu yetympanic. Ukusukela ngeminyaka yee-1950, iingcali zamehlo ziye zayitshintsha ngokuthe ngcembe indlela yokusebenzisa imikroskopu kuphela xa kuhlolwa amehlo kwaye yaziswa.iimicroscopes otosurgicalkuqhaqho lwamehlo. Ukusukela ngoko,I-microscope yokusebenzazisetyenziswe ngokubanzi kwiinkalo ze-otology kunye ne-ophthalmology.

2, Ukusetyenziswa kwe-microscope yotyando kwi-neurosurgery

Ngenxa yobungcali be-neurosurgery, ukusetyenziswa kweiimicroscopes zotyando kwi-neurosurgeryisemva kancinane kune-otology kunye ne-ophthalmology, kwaye oogqirha botyando ngokukhutheleyo bafunda obu buchwepheshe butsha. Ngelo xesha, iukusetyenziswa kweemicroscopes yotyandoubukhulu becala yayiseYurophu. Ugqirha wamehlo waseMelika uPerrit waqala waziswaimikroskopu yotyandoukusuka eYurophu ukuya eUnited States ngo-1946, ubeka isiseko se-American neurosurgeons ukuba basebenziseIimicroscopes ezisebenzayo.

Ngokwembono yokuhlonipha ixabiso lobomi bomntu, nabuphi na ubuchwephesha obutsha, izixhobo, okanye izixhobo ezisetyenziselwa umzimba womntu kufuneka zenze imifuniselo yokuqala yezilwanyana kunye noqeqesho lobuchule kubasebenzi. Ngo-1955, ugqirha wotyando waseMelika uMalis wenza utyando lobuchopho kwizilwanyana esebenzisa aimakroskopu yotyando lwebiyinocular. UKurze, ugqirha wotyando lwemithambo-luvo kwiYunivesithi yaseMazantsi eKhalifoniya eUnited States, wachitha unyaka efunda ubuchule botyando bokusebenzisa imikroskopu elabhoratri emva kokubona utyando lwendlebe ngemicroscope. Ngo-Agasti 1957, wenza ngempumelelo utyando lwe-acoustic neuroma kumntwana oneminyaka emi-5 esebenzisa i-acoustic neuroma.utyando lwendlebe ngemakroskopu, eyayilutyando lokuqala ehlabathini lwe-microsurgery. Kungekudala emva koko, uKurze wenza ngempumelelo i-facial nerve sublingual nerve anastomosis kumntwana esebenzisa i-Imikroskopu yotyando, yaye wachacha kakuhle umntwana. Olu yayilutyando lwesibini lwemicrosurgical ehlabathini. Emva koko, uKurze wasebenzisa iilori ukuthuthaIimicroscopes ezisebenzayokwiindawo ezahlukeneyo kwi-microsurgical neurosurgery, kwaye kucetyiswa ngamandla ukusetyenziswa kweimikroskopu yotyandokwezinye iineurosurgeons. Emva koko, uKurze wenza utyando lwecerebral aneurysm clipping esebenzisa aImikroskopu yotyando(ngelishwa, akazange apapashe nawaphi na amanqaku). Ngenkxaso ye-trigeminal neuralgia isigulane awayiphathayo, waseka i-microskull base base neurosurgery laboratory yokuqala yehlabathi kwi-1961. Kufuneka sihlale sikhumbula igalelo likaKurze kwi-microsurgery kwaye sifunde kwisibindi sakhe sokwamkela ubugcisa obutsha kunye neengcamango. Noko ke, de kwasekuqaleni kweminyaka yee-1990, abanye oogqirha botyando lwemithambo-luvo eTshayina abazange bavumeIimicroscopes zeNeurosurgeryukwenzela utyando. Oku bekungeyongxaki ngeNgemakroskopu yeNeurosurgeryngokwayo, kodwa ingxaki yokuqonda ingcamango yeeurosurgeons.

Ngo-1958, ugqirha wotyando waseMelika uDonaghy waseka ilebhu yokuqala yehlabathi yophando lwemicrosurgery kunye noqeqesho eBurlington, eVermont. Kwinqanaba lokuqala, naye wadibana nokudideka kunye nobunzima bezemali kubaphathi bakhe. Kwimfundo ephakamileyo, wayesoloko enombono wokusika imithambo yegazi ye-cortical evulekileyo ukuze akhuphe ngokuthe ngqo i-thrombi kwizigulana ezine-cerebral thrombosis. Ke uye wasebenzisana nogqirha wotyando lwemithambo uJacobson kwizilwanyana kunye nophando lwezonyango. Ngelo xesha, phantsi kweemeko zeso lenyama, kuphela imithwalo yegazi encinci kunye nobubanzi be-7-8 millimeters okanye ngaphezulu inokuthungwa. Ukufezekisa i-anastomosis yokuphela- ukuya-ekupheleni yemithambo yegazi ecolekileyo, uJacobson waqala wazama ukusebenzisa isimbo seglasi yokukhulisa iglasi. Kungekudala emva koko, wakhumbula ukusebenzisa ii-otolaryngology yotyando yemakroskopuutyando xa wayengugqirha ohlala. Ke, ngoncedo lukaZeiss eJamani, uJacobson wayila imakroskopu yotyando esebenza kabini (IDiploscope) kwi-anastomosis ye-vascular, evumela oogqirha ababini ukuba benze utyando ngaxeshanye. Emva kovavanyo olubanzi lwezilwanyana, uJacobson wapapasha inqaku malunga ne-microsurgical anastomosis yezinja kunye ne-non carotid arteries (1960), kunye ne-100% patency rate ye-vascular anastomosis. Eli liphepha lezonyango eliqhekezayo elinxulumene ne-microsurgical neurosurgery kunye notyando lwe-vascular. UJacobson uphinde wayila izixhobo ezininzi ze-microsurgical, ezifana nesikere esincinci, izibambi zenaliti ezincinci, kunye nezibambo zesixhobo ezincinci. Ngo-1960, u-Donaghy wenza ngempumelelo i-cerebral artery incision thrombectomy phantsi kokuhlinzwa.Imikroskopu yotyandokwisigulane esine-cerebral thrombosis. URhoton wase-United States waqala ukufunda i-anatomy yobuchopho phantsi kwe-microscope ngo-1967, enguvulindlela kwindawo entsha ye-microsurgical anatomy kunye nokwenza igalelo elibalulekileyo kuphuhliso lwe-microsurgery. Ngenxa yeenzuzo zeimikroskopu yotyandokunye nokuphuculwa kwezixhobo ze-microsurgical, ngakumbi nangakumbi oogqirha botyando bathanda ukusebenzisaimikroskopu yotyandoukwenzela utyando. Kwaye yapapasha amanqaku amaninzi ahambelanayo kwiinkqubo ze-microsurgical.

3, Ukusetyenziswa kwe-microscope yotyando kwi-neurosurgery e-China

NjengomTshayina othanda ilizwe laphesheya eJapan, uNjingalwazi uDu Ziwei wanikela ngesixhobo sokuqala sasekhayaI-microscope ye-neurosurgicalkwaye ezinxulumeneizixhobo zemicrosurgicalkwiSebe le-Neurosurgery ye-Suzhou Medical College e-Affiliated Hospital (ngoku i-Neurosurgery Department of Suzhou University Affiliated First Hospital) kwi-1972. Emva kokubuyela e-China, waqala ukwenza utyando lwe-microsurgical njenge-aneurysms ye-intracranial kunye ne-meningiomas. Emva kokufunda malunga nokufumaneka kweiimicroscopes neurosurgicalkunye nezixhobo ze-microsurgical, uNjingalwazi uZhao Yadu ovela kwiSebe le-Neurosurgery laseBeijing Yiwu Hospital utyelele uNjingalwazi uDu Ziwei ovela kwiKholeji yezoNyango yaseSuzhou ukujonga ukusetyenziswaimikroskopu yotyando. Unjingalwazi uShi Yuquan ovela kwiSibhedlele saseShanghai Huashan undwendwele ngokwakhe isebe likaNjingalwazi uDu Ziwei ukujonga iinkqubo zotyando. Ngenxa yoko, igagasi lentshayelelo, ukufunda, kunye nokusetyenziswa kweIimicroscopes zeNeurosurgeryiye yaqala kumaziko amakhulu e-neurosurgery e-China, ephawula ukuqala kwe-micro neurosurgery yase-China.

4, Isiphumo soTyando lweMicrosurgery

Ngenxa yokusetyenziswa kweiimicroscopes neurosurgical, utyando olungenakwenziwa ngeso lenyama lunokwenzeka phantsi kweemeko zokukhulisa amaxesha angama-6-10. Ngokomzekelo, ukwenza utyando lwe-pituitary tumor ngokusebenzisa i-ethmoidal sinus inokuchonga ngokukhuselekileyo kwaye isuse i-pituitary tumors ngelixa ikhusela i-pituitary gland eqhelekileyo; Utyando olungenakwenziwa ngeliso lenyama lunokuba lutyando olungcono, olufana ne-brainstem tumors kunye ne-spinal cord intramedullary tumors. Umfundi wezifundo uWang Zhongcheng wayenezinga lokufa kwe-10.7% ngenxa yotyando lwe-cerebral aneurysm ngaphambi kokusebenzisa i-cerebral aneurysm.i-neurosurgery microscope. Emva kokusebenzisa i-microscope ngo-1978, izinga lokufa liye lehla ukuya kwi-3.2%. Izinga lokusweleka kotyando lwe-cerebral arteriovenous malformation ngaphandle kokusetyenziswa aImikroskopu yotyandoyaba yi-6.2%, kwaye emva ko-1984, ngokusetyenziswa kwe-aiimicroscopes ze-neurosurgery, izinga lokufa lehla ukuya kwi-1.6%. Ukusetyenziswa kwei-neurosurgery microscopeivumela amathumba epituitary ukuba anyangwe ngendlela encinci ye-transnasal transnasal transsphenoidal ngaphandle kwesidingo se-craniotomy, ukunciphisa izinga lokufa kotyando ukusuka kwi-4.7% ukuya kwi-0.9%. Ukufezekiswa kwezi ziphumo akunakwenzeka phantsi kotyando lweliso lwemveli, ngokoimikroskopu yotyandoziluphawu lwe-neurosurgery yanamhlanje kwaye iye yaba sesinye sezixhobo eziyimfuneko kunye nezingenakuphinda zifumaneke endaweni yotyando lwangoku lweneurosurgery.

Imikroskopu yotyando imakroskopu yotyando yotyando lwemicroscope yokusebenza ngemakroskopu yotyando lwemikroskopu yotyando lwemicroscope utyando oluphathekayo imakroskopu imikroskopu utyando lwemikroskopu yamazinyo ent mikroskopu yotyando imikroskopu yamazinyo ikhamera neurosurgery imikroskopu imikroskopu neurosurgical microscopes umatshini osebenzayo imikroskopu. i-ophthalmology imikroskopu yamehlo imakroskopu yamehlo iimakroskopu zotyando imakroskopu yotyando yamehlo esebenza ngemakroskopu yamehlo ophthalmology utyando lomqolo imakroskopu yomqolo imakroskopu yotyando lokuvuselela iplastiki

Ixesha lokuposa: Dec-09-2024