Iyo nhoroondo yekushandisa uye basa rekuvhiya maikorosikopu mune neurosurgery

 

Munhoroondo yeurosurgery, kushandiswa kwemaikorosikopu ekuvhiyachiratidzo chinokatyamadza, kubva panguva yechinyakare neurosurgical era yekuvhiya pasi peziso rakashama kusvika kunguva yemazuva ano yeurosurgical yekuvhiya pasi pemaikorosikopu. Ndiani uye rinhi akaitakushanda maikorosikopukutanga kushandiswa neurosurgery? Ibasa reikuvhiya maikorosikopuakatamba mukuvandudza neurosurgery? Nekufambira mberi kwesainzi uye tekinoroji, kudaMaikorosikopu inoshandaichatsiviwa nemimwe michina yemhando yepamusoro? Uyu mubvunzo unofanirwa kuziva uye kushandisa tekinoroji yazvino uye zviridzwa kumunda weurosurgery, kukurudzira kuvandudzwa kwehunyanzvi hwekuvhiya neurosurgery.

1, Iyo Nhoroondo yeMicroscopy Application muMedical Field

Mufizikisi, malenzi egirazi remaziso ma<em>convex lenzi ane chiumbwa chimwe chete chine hukuru hwekukudza, uye kukudza kwawo kudiki, kunozivikanwa semagirazi ekukudza. Muna 1590, vanhu vaviri vechiDutch vakaisa mahwendefa maviri econvex lens mukati medhiramu mutete, nokudaro vakagadzira mudziyo wekutanga wepasi rose wemuumbi wekukudza: themaikorosikopu. Mushure mezvo, chimiro chemicroscope chakaramba chichivandudzwa, uye kukura kwakawedzera nguva dzose. Panguva iyoyo, masayendisiti ainyanya kushandisa izvicomposite maikorosikopukuona tunhu tudiki twemhuka nezvinomera, sechimiro chemasero. Kubva pakati kusvika pakupera kwezana ramakore rechi 19, magirazi ekukudza uye maikorosikopu zvakashandiswa zvishoma nezvishoma mumunda wemishonga. Pakutanga, vavhiyi vaishandisa magirazi egirazi ekukudza magirazi ane imwe lens chimiro chaigona kuiswa pabhiriji remhuno pakuvhiyiwa. Muna 1876, chiremba weGermany Saemisch akaita kuvhiya kwekutanga pasi “microscopic” achishandisa girazi rinokudza girazi remaziso (rudzi rwekuvhiya haruzivikanwe). Muna 1893, kambani yeGermany Zeiss yakagadzirabinocular maikorosikopu, inonyanya kushandiswa pakuongorora kuongorora mumarabhoritari ezvokurapa, pamwe chete nekucherechedza kwekoroneal uye anterior chamber maronda mumunda we ophthalmology. Muna 1921, zvichibva pakutsvakurudza kwerabhoritari pamusoro pemhuka yemukati nzeve anatomy, Swedish otolaryngologist Nylen akashandisa yakagadziriswa.monocular kuvhiya maikorosikopuyakagadzirwa uye yakagadzirwa naiye pachake kuti aite chirwere chisingaperi che otitis media kuvanhu, iyo yaiva yechokwadi microsurgery. Kwapera gore, chiremba mukuru waNylen Hlolmgren akaunza abinocular kuvhiya maikorosikopuyakagadzirwa naZeiss muimba yekuvhiya.

The earlyMamicroscopes anoshandaaiva nezvakawanda zvimhingamipinyi, zvakadai sekusagadzikana kwemagetsi, kusakwanisa kufamba, kuvhenekera kwematemo akasiyana uye kupisa kwelens yechinangwa, munda wakatetepa wekuvhiya, nezvimwewo. Izvi zvose zvikonzero zvinoderedza kushandiswa kwakakura kwemaikorosikopu ekuvhiya. Mumakore makumi matatu anotevera, nekuda kwekudyidzana kwakanaka pakati pevanovhiya uyevanogadzira maikorosikopu, kuita kwemaikorosikopu ekuvhiyayakaramba ichivandudzwa, uyebinocular kuvhiya maikorosikopu, denga rakaiswa maikorosikopu, zoom lens, coaxial light source illumination, magetsi kana mvura pressure controlled articulated arms, foot pedal control, zvichingodaro zvakatevedzana kugadzirwa. Muna 1953, kambani yeGermany Zeiss yakagadzira dzakatevedzana nyanzvimicroscopes yekuvhiya yeotology, kunyanya yakakodzera kuvhiyiwa pamaronda akadzika akadai sepakati nzeve uye temporal bone. Nepo kuita kwemaikorosikopu ekuvhiyainoramba ichivandudza, mafungiro evanovhiya ari kuramba achichinja. Somuenzaniso, vanachiremba vokuGermany Zollner naWullstein vakataura izvozvomaikorosikopu ekuvhiyainofanira kushandiswa pakuvhiya kwe tympanic membrane kuumba. Kubva kuma1950, vanachiremba vemaziso vakachinja zvishoma nezvishoma tsika yekushandisa maikorosikopu chete pakuongorora maziso uye yakatanga.otosurgical microscopeskupinda ophthalmic surgery. Kubva ipapo,Maikorosikopu inoshandayakashandiswa zvakanyanya muminda yeotology uye ophthalmology.

2, Kushandiswa kwekuvhiya maikorosikopu mune neurosurgery

Nekuda kwehunyanzvi hwekuita neurosurgery, kushandiswa kwemicroscopes yekuvhiya mune neurosurgeryiri gare gare zvishoma pane otology uye ophthalmology, uye neurosurgeons vari kushingaira kudzidza iyi tekinoroji nyowani. Panguva iyoyo, thekushandisa maikorosikopu ekuvhiyayakanga iri kunyanya kuEurope. American ophthalmologist Perrit akatanga kuunzwamaikorosikopu ekuvhiyakubva kuEurope kuenda kuUnited States muna 1946, vachiisa hwaro hwevaAmerican neurosurgeons kuti vashandiseMamicroscopes anoshanda.

Kubva pakuona kwekuremekedza kukosha kwehupenyu hwemunhu, chero tekinoroji nyowani, midziyo, kana zviridzwa zvinoshandiswa kumuviri wemunhu zvinofanirwa kupinda muongororo yekutanga yemhuka uye kudzidziswa kwehunyanzvi kune vanoshanda. Muna 1955, American neurosurgeon Malis akavhiya uropi pamhuka achishandisa abinocular kuvhiya maikorosikopu. Kurze, chiremba anovhiya tsinga paUniversity of Southern California muUnited States, akapedza gore achidzidza nzira dzokuvhiya dzokushandisa maikorosikopu murabhoritari pashure pokunge aona kuvhiyiwa nzeve nemaikorosikopu. Muna Nyamavhuvhu 1957, akabudirira kuita acoustic neuroma oparesheni pamwana ane makore mashanukuvhiya nzeve maikorosikopu, uko kwaiva kuvhiyiwa kwokutanga pasi rose kwemicrosurgical. Nguva pfupi yapfuura, Kurze akabudirira kuita facial nerve sublingual nerve anastomosis pamwana achishandisa akuvhiya maikorosikopu, uye kupora kwomwana kwakanga kwakanakisisa. Uku kwaive kuvhiya kwechipiri kwemicrosurgical munyika. Pashure pacho, Kurze akashandisa marori kutakuraMamicroscopes anoshandakunzvimbo dzakasiyana-siyana dze microsurgical neurosurgery, uye yakakurudzira zvakasimba kushandiswa kwemaikorosikopu ekuvhiyakune mamwe ma neurosurgeons. Mushure mezvo, Kurze akavhiya cerebral aneurysm clipping uchishandisa akuvhiya maikorosikopu(zvinosuruvarisa, haana kubudisa chero zvinyorwa). Nerutsigiro rwemurwere wetrigeminal neuralgia waakarapa, akatanga nyika yekutanga microskull base neurosurgery laboratory muna 1961. Tinofanira kugara tichiyeuka kubatsira kwaKurze ku microsurgery uye kudzidza kubva paushingi hwake hwekugamuchira hutsva hutsva uye mazano. Zvisinei, kutozosvikira kutanga kwema1990, mamwe ma<em>neurosurgeon muChina haana kubvumaNeurosurgery maikorosikopuyekuvhiya. Iri rakanga risiri dambudziko naroNeurosurgery maikorosikopupachayo, asi dambudziko nekunzwisisa kwevaneurosurgeons.

Muna 1958, American neurosurgeon Donaghy akatanga pasi rose microsurgery research and training laboratory muBurlington, Vermont. Mumatanho ekutanga, akasanganawo nekuvhiringidzika uye matambudziko emari kubva kuvakuru vake. Muchikoro, aigara achifungidzira kucheka tsinga dzeropa dzakavhurika kuti dzibvise zvakananga thrombi kubva kuvarwere vane cerebral thrombosis. Saka akabatana nachiremba anovhiya vascular Jacobson pamhuka uye tsvakurudzo yekiriniki. Panguva iyoyo, pasi pemamiriro eziso rakashama, mitsipa miduku chete yeropa ine dhayamita ye7-8 millimeters kana kupfuura inogona kuiswa. Kuti uwane kupedzisa-kusvika-kumagumo anastomosis yemidziyo yeropa yakatsetseka, Jacobson akatanga kuedza kushandisa girazi rekukudza girazi. Nenguva isipi, akayeuka kushandisaotolaryngology kuvhiya maikorosikopukuvhiyiwa paakanga ari chiremba aigara. Saka, nerubatsiro rweZeiss kuGermany, Jacobson akagadzira maviri maviri ekuvhiya maikorosikopu (Diploscope) yevascular anastomosis, iyo inobvumira vanachiremba vaviri kuti vaite kuvhiyiwa panguva imwe chete. Mushure mekuedza kwakawanda kwemhuka, Jacobson akaburitsa chinyorwa nezve microsurgical anastomosis yembwa uye isiri carotid arteries (1960), ine 100% patency rate yevascular anastomosis. Iri ipepa rekurapa rinoputika rine chekuita ne microsurgical neurosurgery uye kuvhiyiwa kwevascular. Jacobson akagadzirawo akawanda microsurgical zviridzwa, senge micro scissors, micro tsono zvibatiso, uye micro chiridzwa zvibato. Muna 1960, Donaghy akabudirira kuita cerebral artery incision thrombectomy pasi pekuvhiya maikorosikopukune murwere ane cerebral thrombosis. Rhoton anobva kuUnited States akatanga kufunda anatomi yehuropi pasi pemaikorosikopu muna 1967, achipayona nzvimbo itsva yemicrosurgical anatomy uye kuita mipiro yakakosha mukuvandudzwa kwemicrosurgery. Nekuda kwezvakanakiramaikorosikopu ekuvhiyauye kuvandudzwa kwezviridzwa zve microsurgical, vazhinji uye vazhinji vanovhiya vanofarira kushandisamaikorosikopu ekuvhiyayekuvhiya. Uye yakaburitsa zvinyorwa zvakawanda zvine chekuita nezve microsurgical maitiro.

3, Kushandiswa kwekuvhiya maikorosikopu mune neurosurgery muChina

SemuChina anofarira nyika yake ari mhiri kwemakungwa muJapan, Purofesa Du Ziwei akapa yekutanga yepambaneurosurgical microscopeuye zvinoenderanamicrosurgical zviridzwakuDhipatimendi reNeurosurgery reSuzhou Medical College Affiliated Hospital (zvino yava Neurosurgery Department yeSuzhou University Affiliated First Hospital) muna 1972. Mushure mokudzokera kuChina, akatanga kuita microsurgical surgeries zvakadai se intracranial aneurysms uye meningiomas. Mushure mekudzidza nezve kuwanikwa kweneurosurgical microscopesuye michina yekuvhiya, Muzvinafundo Zhao Yadu weDhipatimendi reNeurosurgery yeBeijing Yiwu Hospital akashanyira Purofesa Du Ziwei kubva kuSuzhou Medical College kuti aone kushandiswa kwemaikorosikopu ekuvhiya. Muzvinafundo Shi Yuquan anobva kuShanghai Huashan Hospital akashanyira dhipatimendi raProfessor Du Ziwei kuti vaone maitiro ekuvhiya. Nekuda kweizvozvo, mafungu ekusuma, kudzidza, uye kushandiswa kweNeurosurgery maikorosikopuyakamutswa munzvimbo huru dzekuvhiya neurosurgery muChina, zvichiratidza kutanga kweChina microsurgery.

4, Mhedzisiro yeMicrosurgery Surgery

Nekuda kwekushandiswa kweneurosurgical microscopes, kuvhiyiwa kusingakwanisi kuitwa neziso rakashama kunogoneka pasi pemamiriro ekukudza kwe6-10 nguva. Semuyenzaniso, kuita pituitary bundu kuvhiya kuburikidza ethmoidal sinus anogona zvakachengeteka kuziva uye kubvisa pituitary mapundu panguva kudzivirira yakajairika pituitary gland; Kuvhiya kusingagone kuitwa neziso rakashama kunogona kuve kuvhiya kuri nani, senge brainstem tumors uye spinal cord intramedullary tumors. Academician Wang Zhongcheng aive nehuwandu hwekufa kwe10.7% pakuvhiyiwa kwecerebral aneurysm asati ashandisaneurosurgery maikorosikopu. Mushure mekushandisa maikorosikopu muna 1978, nhamba yekufa yakaderera kusvika 3.2%. Huwandu hwekufa kwecerebral arteriovenous malformation operation pasina kushandisa akuvhiya maikorosikopuyaive 6.2%, uye mushure me1984, nekushandiswa kweneurosurgery maikorosikopu, nhamba yekufa yakaderera kusvika ku1,6%. Kushandiswa kweneurosurgery maikorosikopuinobvumira mapundu epituitary kuti arapwe kuburikidza neashoma anopinda transnasal transsphenoidal nzira pasina kudiwa kwecraniotomy, kuderedza huwandu hwekufa kwekuvhiya kubva pa4,7% kusvika 0.9%. Kubudirira kweizvi mhedzisiro hazvigoneke pasi pechinyakare gross kuvhiyiwa kweziso, sakamaikorosikopu ekuvhiyachiratidzo chemazuva ano neurosurgery uye chave chimwe chezvinhu zvakakosha uye zvisingadzokerike zvekuvhiya zvemazuva ano neurosurgery.