Tarihin aikace-aikacen da rawar microscopes na tiyata a cikin neurosurgery

 

A cikin tarihin neurosurgery, aikace-aikace namicroscopes na tiyataalama ce mai ban sha'awa, wanda ya ci gaba tun daga zamanin gargajiya na aikin tiyata a karkashin ido tsirara zuwa zamanin aikin tiyata na zamani na yin tiyata a karkashinmicroscope. Wanene kuma yaushe yayimicroscopes masu aikifara amfani da su a neurosurgery? Wace rawa yake da itamicroscope na tiyatataka a ci gaban neurosurgery? Tare da ci gaban kimiyya da fasaha, soMicroscope mai aikiza a maye gurbinsu da wasu ƙarin kayan aikin ci gaba? Wannan tambaya ce da ya kamata kowane likitan neurosurgery ya sani da kuma amfani da sabbin fasahohi da kayan aiki a fagen aikin tiyatar jijiya, yana inganta haɓaka dabarun aikin tiyatar jijiya.

1. Tarihin Aikace-aikacen Microscope a cikin Filin Kiwon Lafiya

A ilimin kimiyyar lissafi, ruwan tabarau na gilashin ido su ne nau'in ruwan tabarau masu dunƙulewa tare da tsari guda ɗaya wanda ke da tasirin haɓakawa, kuma girman girman su yana da iyaka, wanda aka sani da gilashin ƙara girma. A cikin 1590, mutanen Holland guda biyu sun shigar da faranti biyu na ruwan tabarau a cikin siririyar ganga cylindrical, don haka suka ƙirƙira na'urar haɓaka tsari ta farko a duniya:microscope. Bayan haka, an ci gaba da inganta tsarin na'urar microscope, kuma haɓakawa ya karu ci gaba. A lokacin, masana kimiyya sun fi amfani da wannanhadadden microscopedon lura da ƙananan sifofin dabbobi da tsirrai, kamar tsarin sel. Tun daga tsakiyar karni zuwa ƙarshen karni na 19, a hankali an yi amfani da gilashin ƙararrawa da na'urori masu ƙima a fannin likitanci. Da farko, likitocin sun yi amfani da irin nau'in gilashin da ke ƙara girman tabarau tare da tsarin ruwan tabarau guda ɗaya wanda za'a iya sanya shi a kan gadar hanci don tiyata. A shekara ta 1876, likita dan kasar Jamus Saemisch ya yi tiyatar “microscopic” ta farko a duniya ta amfani da gilashin kara girman gilashin ido (nau'in tiyata ba a san shi ba). A cikin 1893, kamfanin Jamus Zeiss ya ƙirƙirabinocular microscope, wanda aka fi amfani dashi don dubawa na gwaji a cikin dakunan gwaje-gwaje na likita, da kuma lura da raunuka na corneal da na baya a cikin fannin ilimin ophthalmology. A cikin 1921, bisa ga binciken dakin gwaje-gwaje akan jikin kunnen dabba na ciki, likitan dan kasar Sweden Nylen ya yi amfani da kayyade.monocular tiyata microscopeda kansa ya ƙera kuma ya ƙera shi don yin aikin tiyata na otitis na yau da kullun akan mutane, wanda shine ainihin microsurgery. Bayan shekara guda, babban likitan Nylen Hlolmgren ya gabatar da wanibinocular tiyata microscopeZeiss ne ya kera shi a cikin dakin tiyata.

FarkonMicroscopes masu aikiyana da yawa drawbacks, irin su matalauta inji kwanciyar hankali, rashin iya motsawa, haske na daban-daban gatari da dumama na haƙiƙa ruwan tabarau, kunkuntar tiyata magnification filin, da dai sauransu Waɗannan su ne duk dalilan da iyakance fadi aikace-aikace namicroscopes na tiyata. A cikin shekaru talatin masu zuwa, saboda kyakkyawar mu'amala tsakanin likitocin fiɗa damicroscope masana'antun, aikin namicroscopes na tiyataaka ci gaba da inganta, kumabinocular tiyata microscopes, rufin saka microscopes, zuƙowa ruwan tabarau, coaxial haske tushen haske, lantarki ko ruwa sarrafa ikon articulated makamai, kafa fedal iko, da sauransu an ci gaba a jere. A cikin 1953, kamfanin Jamus Zeiss ya samar da jerin ƙwararrumicroscopes na tiyata don otology, musamman dacewa da tiyata akan raunuka masu zurfi kamar kunnen tsakiya da kashi na lokaci. Yayin da aikinmicroscopes na tiyataya ci gaba da ingantawa, tunanin likitocin tiyata kuma yana canzawa akai-akai. Misali, likitocin Jamus Zollner da Wullstein sun ƙulla da hakanmicroscopes na tiyatadole ne a yi amfani da tympanic membrane siffata tiyata. Tun daga shekarun 1950, likitocin ido a hankali sun canza al'adar yin amfani da microscopes kawai don gwajin ido kuma an gabatar da su.otosurgical microscopeszuwa tiyatar ido. Tun daga nan,Microscope mai aikian yi amfani da su sosai a fagen otology da ophthalmology.

2. Aikace-aikacen microscope na tiyata a cikin neurosurgery

Saboda musamman neurosurgery, aikace-aikace namicroscopes na tiyata a cikin neurosurgeryya ɗan jima baya fiye da na otology da ophthalmology, kuma likitocin neurosurgeons suna koyan wannan sabuwar fasaha sosai. A lokacin, daamfani da microscopes na tiyataya kasance a Turai. Likitan ido na Amurka Perrit ya fara gabatar da shimicroscopes na tiyatadaga Turai zuwa Amurka a cikin 1946, wanda ya kafa harsashin likitocin Amurka don amfani da suMicroscopes masu aiki.

Daga mahangar mutunta darajar rayuwar ɗan adam, duk wani sabon fasaha, kayan aiki, ko kayan aikin da ake amfani da su ga jikin ɗan adam ya kamata a yi gwajin dabbobi na farko da horon fasaha ga masu aiki. A cikin 1955, likitan neurosurgeon dan Amurka Malis ya yi wa dabbobi tiyata a kwakwalwa ta hanyar amfani da abinocular tiyata microscope. Kurze, likitan tiyata a jami’ar Kudancin California da ke Amurka, ya shafe shekara guda yana koyon dabarun tiyatar yin amfani da na’urar gani da ido a dakin gwaje-gwaje bayan ya lura da tiyatar kunne ta na’ura mai kwakwalwa. A cikin watan Agustan 1957, ya yi nasarar yin aikin tiyatar neuroma na acoustic a kan wani yaro mai shekaru 5 ta amfani damicroscope tiyatar kunne, wanda shine aikin tiyata na farko a duniya. Ba da daɗewa ba bayan haka, Kurze ya yi nasarar yin gyaran fuska jijiyoyi sublingual anastomosis akan yaron ta amfani da amicroscope na tiyata, kuma lafiyar yaron ya yi kyau. Wannan shi ne tiyata na biyu na microsurgical a duniya. Bayan haka, Kurze ya yi amfani da manyan motoci don ɗaukaMicroscopes masu aikizuwa wurare daban-daban don microsurgical neurosurgery, kuma ya ba da shawarar yin amfani da shi sosaimicroscopes na tiyatazuwa sauran likitocin neurosurgeons. Bayan haka, Kurze ya yi aikin yankan ƙwayar cuta ta cerebral aneurysm ta amfani da amicroscope na tiyata(Abin takaici, bai buga wani labari ba). Tare da goyon bayan mai ciwon neuralgia na trigeminal da ya bi da shi, ya kafa dakin gwaje-gwaje na farko na micro skull tushe neurosurgery a cikin 1961. Ya kamata mu tuna da gudummawar Kurze ga microsurgery kuma mu koyi daga ƙarfinsa don karɓar sababbin fasaha da ra'ayoyi. Duk da haka, har zuwa farkon shekarun 1990, wasu likitocin jinya a kasar Sin ba su yarda baMicroscopes neurosurgerydomin tiyata. Wannan ba matsala ba ceMicroscope na neurosurgerykanta, amma matsala tare da fahimtar akidar neurosurgeons.

A cikin 1958, likitan neurosurgeon na Amurka Donaghy ya kafa bincike na farko na microsurgery da dakin gwaje-gwaje na horo a Burlington, Vermont. A farko-farkon ya kuma gamu da rudani da matsalar kudi daga manyansa. A cikin ilimin kimiyya, koyaushe yana tunanin yanke buɗaɗɗen tasoshin jini don cire thrombi kai tsaye daga marasa lafiya da thrombosis na cerebral. Don haka ya yi aiki tare da likitan jijiyoyin jini Jacobson akan binciken dabba da na asibiti. A lokacin, a ƙarƙashin yanayin ido tsirara, ƙananan tasoshin jini da diamita na 7-8 millimeters ko fiye za a iya suture. Domin cimma anastomosis na ƙarshen-zuwa-ƙarshe na mafi kyawun hanyoyin jini, Jacobson ya fara ƙoƙarin yin amfani da gilashin ƙara girman salon tabarau. Ba da da ewa bayan, ya tuno da yin amfani da waniotolaryngology tiyata microscopedomin tiyata a lokacin da yake mazaunin likita. Don haka, tare da taimakon Zeiss a Jamus, Jacobson ya ƙera na'urar duban ma'aikacin tiyata na dual.Diploscope) don anastomosis na jijiyoyin jini, wanda ke ba da damar likitocin biyu suyi aikin tiyata a lokaci guda. Bayan gwaje-gwajen dabbobi masu yawa, Jacobson ya buga labarin akan anastomosis na microsurgical na karnuka da jijiyoyin marasa carotid (1960), tare da ƙimar 100% na anastomosis na jijiyoyin jini. Wannan takarda ce ta likitanci da ke da alaƙa da ƙananan ƙwayoyin cuta neurosurgery da tiyata na jijiyoyin jini. Jacobson kuma ya ƙera na'urori masu ƙima da yawa, kamar ƙananan almakashi, masu riƙe da ƙananan allura, da ƙananan kayan hannu. A cikin 1960, Donaghy ya yi nasarar aiwatar da thrombectomy cerebral artery incision thrombectomy a karkashinmicroscope na tiyataga mai haƙuri tare da thrombosis cerebral. Rhoton daga kasar Amurka ya fara nazarin ilimin halittar kwakwalwa a karkashin na’urar hangen nesa a shekarar 1967, inda ya fara yin wani sabon fanni na aikin tiyatar microsurgical da kuma bayar da gagarumar gudunmawa ga bunkasar kananan yara. Saboda fa'idarmicroscopes na tiyatada haɓaka kayan aikin ƙananan ƙwayoyin cuta, ƙarin likitocin fiɗa suna sha'awar amfani da sumicroscopes na tiyatadomin tiyata. Kuma an buga labarai masu alaƙa da yawa akan hanyoyin microsurgical.

3. Aikace-aikacen microscope na tiyata a cikin neurosurgery a China

A matsayinsa na dan kasar Sin mai kishin kasa a ketare a kasar Japan, Farfesa Du Ziwei ya ba da gudummawar gida na farkoneurosurgical microscopeda alakakayan aikin microsurgicalzuwa Sashen tiyata na Neurosurgery na asibitin Suzhou Medical College (yanzu sashen Neurosurgery na Asibitin Farko na Jami'ar Suzhou) a cikin 1972. Bayan ya dawo kasar Sin, ya fara yin tiyatar kananan yara kamar su aneurysms na ciki da kuma meningiomas. Bayan koyo game da samuwarneurosurgical microscopesda na'urorin aikin tiyata, Farfesa Zhao Yadu daga Sashen tiyata na Neurosurgery na Asibitin Yiwu na Beijing ya ziyarci Farfesa Du Ziwei daga Kwalejin Kiwon Lafiya ta Suzhou don lura da yadda ake amfani da su.microscopes na tiyata. Farfesa Shi Yuquan daga Asibitin Huashan na Shanghai da kansa ya ziyarci sashen Farfesa Du Ziwei don duba hanyoyin da ake yi wa kananan yara. Sakamakon haka, guguwar gabatarwa, koyo, da aikace-aikace naMicroscopes neurosurgeryAn taso ne a manyan cibiyoyin aikin tiyatar jijiya a kasar Sin, lamarin da ya nuna mafarin aikin tiyatar dan adam na kasar Sin.

4.Tasirin Tiyatar Microsurgery

Sakamakon amfani daneurosurgical microscopes, tiyatar da ba za a iya yi da ido tsirara ba ta zama mai yiwuwa a ƙarƙashin yanayin girma na sau 6-10. Misali, yin tiyatar ƙwayar cuta ta pituitary ta hanyar ethmoidal sinus na iya ganowa da cire ciwace-ciwacen pituitary cikin aminci cikin aminci yayin da ake kare glandan pituitary na al'ada; Tiyatar da ba za a iya yi da ido tsirara ba na iya zama fiɗa mafi kyau, kamar su ciwace-ciwacen ƙwayar cuta da ciwace-ciwacen ƙwayoyin cuta. Masanin ilimin kimiyya Wang Zhongcheng yana da adadin mace-mace da kashi 10.7 cikin dari na aikin tiyata na cerebral aneurysm kafin amfani da shi.microscope na neurosurgery. Bayan amfani da na'urar hangen nesa a cikin 1978, yawan mace-mace ya ragu zuwa 3.2%. Adadin mace-macen tiyatar rashin lafiyar kwakwalwar jijiyoyin jijiya ba tare da amfani da amicroscope na tiyataya kasance 6.2%, kuma bayan 1984, tare da amfani da amicroscopes neurosurgery, yawan mace-macen ya ragu zuwa 1.6%. Amfani damicroscope na neurosurgeryyana ba da damar yin amfani da ciwace-ciwacen ƙwayar cuta ta hanyar ɗan ƙaramin ɓarna na transsphenoidal transnasal ba tare da buƙatar craniotomy ba, yana rage yawan mace-mace daga 4.7% zuwa 0.9%. Samun nasarar waɗannan sakamakon ba zai yiwu ba a ƙarƙashin babban aikin ido na gargajiya, don hakamicroscopes na tiyataalama ce ta aikin tiyatar jijiya na zamani kuma sun zama ɗaya daga cikin kayan aikin tiyata da ba makawa kuma ba za a iya maye gurbinsu ba a cikin aikin tiyata na zamani.