Daim ntawv thov keeb kwm thiab lub luag haujlwm ntawm kev phais microscopes hauv neurosurgery

 

Hauv keeb kwm ntawm neurosurgery, daim ntawv thov ntawmphais microscopesyog lub cim tseem ceeb, nce los ntawm cov tsoos neurosurgical era ntawm kev phais nyob rau hauv lub qhov muag liab qab mus rau niaj hnub neurosurgical era ntawm kev phais nyob rau hauv ib tugmicroscope. Leej twg thiab thaum twg uaua haujlwm microscopespib siv rau hauv neurosurgery? Lub luag haujlwm twg muajphais microscopeua si nyob rau hauv txoj kev loj hlob ntawm neurosurgery? Nrog rau kev nce qib ntawm science thiab technology, yuavUa haujlwm microscopetau hloov los ntawm qee yam khoom siv siab tshaj? Qhov no yog ib lo lus nug uas txhua tus kws kho mob neurosurgeon yuav tsum paub txog thiab siv cov cuab yeej tshiab thiab cov cuab yeej siv rau thaj tsam ntawm neurosurgery, txhawb kev txhim kho ntawm kev phais mob neurosurgery.

1, Keeb Kwm ntawm Kev Siv Microscopy hauv Kev Kho Mob

Hauv physics, cov tsom iav qhov muag yog cov lo ntsiab muag convex nrog ib tus qauv uas muaj cov nyhuv magnifying, thiab lawv cov magnification yog txwv, hu ua magnifying iav. Xyoo 1590, ob tus neeg Dutch tau teeb tsa ob lub ntsej muag lub ntsej muag rau hauv lub thoob cylindrical, yog li tsim lub ntiaj teb thawj cov qauv sib xyaw ua kom zoo nkauj:microscope. Tom qab ntawd, cov qauv ntawm lub tshuab ntsuas tshuab tau zoo tas li, thiab qhov kev nthuav dav tau nce mus tas li. Lub sijhawm ntawd, cov kws tshawb fawb feem ntau siv qhov nocomposite microscopelos soj ntsuam cov qauv me me ntawm cov tsiaj thiab cov nroj tsuag, xws li cov qauv ntawm cov hlwb. Txij li thaum nruab nrab mus rau lub xyoo pua puv 19, cov tsom iav tsom iav thiab cov tsom iav tsom iav tau maj mam siv rau hauv cov tshuaj. Thaum xub thawj, cov kws phais siv cov tsom iav qhov muag tsom iav nrog ib lub lens qauv uas tuaj yeem muab tso rau ntawm tus choj ntawm lub qhov ntswg rau kev phais. Xyoo 1876, tus kws kho mob German Saemisch tau ua lub ntiaj teb thawj qhov kev phais "microscopic" siv lub iav tsom iav sib xyaw (hom kev phais tsis paub). Xyoo 1893, lub tuam txhab German Zeiss tau tsim lubbinocular microscope, feem ntau yog siv rau kev soj ntsuam kev soj ntsuam hauv cov chaw kuaj mob, nrog rau kev soj ntsuam ntawm pob txha thiab cov kab mob sab hauv lub qhov txhab hauv thaj tsam ntawm ophthalmology. Nyob rau hauv 1921, raws li nyob rau hauv lub chaw soj nstuam kev tshawb fawb ntawm cov tsiaj puab pob ntseg anatomy, Swedish otolaryngologist Nylen siv ib tug taag.monocular phais microscopetsim thiab tsim los ntawm nws tus kheej los ua kev phais mob otitis media rau tib neeg, uas yog qhov tseeb microsurgery. Ib xyoos tom qab, Nylen tus kws kho mob zoo tshaj Hlolmgren tau qhia txog ib qhobinocular phais microscopetsim los ntawm Zeiss hauv chav ua haujlwm.

Thaum ntxovUa haujlwm microscopesmuaj ntau yam drawbacks, xws li cov neeg kho tshuab tsis zoo, tsis muaj peev xwm txav, illumination ntawm txawv axes thiab cua sov ntawm lub hom phiaj lens, nqaim phais magnification teb, thiab lwm yam. Cov no yog tag nrho cov laj thawj uas txwv qhov dav ntawm daim ntawv thov.phais microscopes. Hauv peb caug xyoo tom ntej no, vim muaj kev sib cuam tshuam zoo ntawm cov kws phais thiabmicroscope manufacturers, kev ua haujlwm ntawmphais microscopestau txhim kho tsis tu ncua, thiabbinocular phais microscopes, ru tsev mounted microscopes, zoom lo ntsiab muag, coaxial light source illumination, hluav taws xob los yog dej siab tswj articulated caj npab, ko taw pedal tswj, thiab thiaj li nyob rau hauv successively tsim. Xyoo 1953, lub tuam txhab German Zeiss tau tsim cov khoom tshwj xeebphais microscopes rau otology, tshwj xeeb tshaj yog tsim nyog rau kev phais ntawm cov kab mob sib sib zog nqus xws li pob ntseg nruab nrab thiab lub cev nqaij daim tawv. Thaum kev ua haujlwm ntawmphais microscopestxuas ntxiv txhim kho, lub siab xav ntawm cov kws phais kuj tseem hloov pauv tas li. Piv txwv li, German kws kho mob Zollner thiab Wullstein tau hais tiasphais microscopesyuav tsum tau siv rau tympanic membrane shaping phais. Txij li thaum xyoo 1950, cov kws kho mob ophthalmologists tau maj mam hloov qhov kev coj ua ntawm kev siv lub tshuab tsom iav nkaus xwb rau kev kuaj mob ophthalmic thiab qhia.otosurgical microscopesnyob rau hauv ophthalmic phais. Txij thaum ntawd los,Ua haujlwm microscopetau siv dav hauv thaj chaw ntawm otology thiab ophthalmology.

2 、 Daim ntawv thov kev phais microscope hauv neurosurgery

Vim qhov tshwj xeeb ntawm neurosurgery, daim ntawv thov ntawmphais microscopes hauv neurosurgeryyog me ntsis tom qab nyob rau hauv otology thiab ophthalmology, thiab neurosurgeons nquag kawm no tshiab technology. Thaum ntawd, lubsiv cov microscopes phaisyog nyob rau hauv cov teb chaws Europe. American ophthalmologist Perrit thawj zaug qhiaphais microscopeslos ntawm Tebchaws Europe mus rau Tebchaws Meskas hauv xyoo 1946, tso lub hauv paus rau Asmeskas cov kws kho mob neurosurgeons sivUa haujlwm microscopes.

Los ntawm qhov kev xav ntawm kev hwm tus nqi ntawm tib neeg lub neej, txhua yam tshiab, cov cuab yeej siv, lossis cov cuab yeej siv rau tib neeg lub cev yuav tsum tau txais kev sim tsiaj ua ntej thiab kev cob qhia rau cov neeg ua haujlwm. Xyoo 1955, American neurosurgeon Malis tau ua kev phais hlwb ntawm cov tsiaj uas siv abinocular phais microscope. Kurze, kws phais neeg mob hlwb ntawm University of Southern California hauv Tebchaws Meskas, tau siv sijhawm ib xyoos kawm txog kev phais mob ntawm kev siv lub tshuab kuaj kab mob hauv lub chaw kuaj mob tom qab soj ntsuam pob ntseg phais hauv lub tshuab ntsuas. Thaum Lub Yim Hli 1957, nws tau ua tiav kev phais mob acoustic neuroma rau tus menyuam hnub nyoog 5 xyoos siv ib qhopob ntseg phais microscope, uas yog lub ntiaj teb thawj zaug kev phais microsurgical. Tsis ntev tom qab ntawd, Kurze tau ua tiav lub ntsej muag paj hlwb sublingual paj hlwb anastomosis ntawm tus menyuam siv lub ntsej muag.phais microscope, thiab tus me nyuam txoj kev rov zoo tau zoo heev. Qhov no yog qhov kev phais microsurgical thib ob hauv ntiaj teb. Tom qab ntawd, Kurze siv tsheb thauj mus losUa haujlwm microscopesmus rau ntau qhov chaw rau microsurgical neurosurgery, thiab pom zoo kom sivphais microscopesrau lwm tus kws kho mob neurosurgeons. Tom qab ntawd, Kurze tau ua cerebral aneurysm clipping phais siv aphais microscope(Hmoov tsis zoo, nws tsis tau luam tawm ib tsab xov xwm). Nrog kev txhawb nqa ntawm tus neeg mob trigeminal neuralgia nws kho, nws tau tsim lub ntiaj teb thawj micro pob txha taub hau hauv lub hauv paus neurosurgery laboratory hauv xyoo 1961. Peb yuav tsum nco ntsoov Kurze txoj kev koom tes rau microsurgery thiab kawm los ntawm nws lub siab tawv kom lees txais cov thev naus laus zis thiab cov tswv yim tshiab. Txawm li cas los xij, txog thaum xyoo 1990, qee tus kws kho mob hauv Suav teb tsis lees txaisNeurosurgery microscopesrau kev phais. Qhov no tsis yog ib qho teeb meem nrog rauNeurosurgery microscopenws tus kheej, tab sis muaj teeb meem nrog neurosurgeons 'ideological nkag siab.

Nyob rau hauv 1958, American neurosurgeon Donaghy tau tsim lub ntiaj teb thawj microsurgery kev tshawb fawb thiab kev cob qhia kuaj hauv Burlington, Vermont. Thaum ntxov, nws kuj ntsib kev tsis meej pem thiab nyiaj txiag nyuaj los ntawm nws cov thawj coj. Hauv kev kawm, nws ib txwm xav txog kev txiav cov hlab ntsha cortical ncaj qha los ntawm cov neeg mob cerebral thrombosis. Yog li nws tau koom tes nrog tus kws phais mob vascular Jacobson ntawm kev tshawb fawb tsiaj thiab kev kho mob. Thaum lub sijhawm ntawd, nyob rau hauv cov xwm txheej ntawm qhov muag liab qab, tsuas yog cov hlab ntsha me me uas muaj txoj kab uas hla ntawm 7-8 millimeters lossis ntau dua tuaj yeem raug sutured. Txhawm rau kom ua tiav qhov kawg-rau-kawg anastomosis ntawm cov hlab ntsha zoo dua, Jacobson thawj zaug sim siv cov iav tsom iav zoo nkauj. Tsis ntev tom qab, nws nco qab siv ib qhootolaryngology phais microscoperau kev phais thaum nws yog ib tug kws kho mob nyob. Yog li, nrog kev pab los ntawm Zeiss nyob rau hauv lub teb chaws Yelemees, Jacobson tsim ib tug dual tus neeg teb xov tooj phais microscope (Diploscope) rau vascular anastomosis, uas tso cai rau ob tug kws phais neeg ua qhov kev phais ib txhij. Tom qab kev sim tsiaj ntau, Jacobson tau luam tawm ib tsab xov xwm ntawm microsurgical anastomosis ntawm cov dev thiab cov hlab ntsha uas tsis yog carotid (1960), nrog rau 100% patency tus nqi ntawm vascular anastomosis. Qhov no yog ib daim ntawv kho mob uas muaj feem xyuam nrog microsurgical neurosurgery thiab vascular phais. Jacobson kuj tau tsim ntau yam cuab yeej microsurgical, xws li micro txiab, micro koob tuav, thiab micro ntsuas tes. Nyob rau hauv 1960, Donaghy tau ua tiav ib lub paj hlwb incision thrombectomy nyob rau hauv ib tugphais microscoperau tus neeg mob uas muaj cerebral thrombosis. Rhoton los ntawm Tebchaws Meskas tau pib kawm lub hlwb anatomy nyob rau hauv lub tshuab kuaj kab mob hauv xyoo 1967, tau pib ua haujlwm tshiab ntawm microsurgical anatomy thiab ua haujlwm tseem ceeb rau kev txhim kho microsurgery. Vim qhov zoo ntawmphais microscopesthiab kev txhim kho cov cuab yeej microsurgical, ntau thiab ntau tus kws phais mob nyiam sivphais microscopesrau kev phais. Thiab tau luam tawm ntau cov lus hais txog cov txheej txheem microsurgical.

3 、 Daim ntawv thov ntawm kev phais microscope hauv neurosurgery hauv Suav teb

Raws li ib tug neeg nyiam nyob txawv teb chaws Suav hauv Nyij Pooj, Xib Fwb Du Ziwei tau pub thawj zaug hauv tsevneurosurgical microscopethiab hais txogcov cuab yeej microsurgicalmus rau Neurosurgery Department ntawm Suzhou Medical College Affiliated Tsev Kho Mob (tam sim no lub Neurosurgery Department ntawm Suzhou University Affiliated First Hospital) nyob rau hauv 1972. Tom qab rov qab mus rau Tuam Tshoj, nws thawj zaug ua microsurgical phais xws li intracranial aneurysms thiab meningiomas. Tom qab kawm txog qhov muaj ntawmneurosurgical microscopesthiab microsurgical instruments, xibfwb Zhao Yadu los ntawm Neurosurgery Department ntawm Beijing Yiwu Tsev Kho Mob tau mus ntsib xibfwb Du Ziwei los ntawm Suzhou Medical College los soj ntsuam kev siv.phais microscopes. Xib fwb Shi Yuquan los ntawm Shanghai Huashan Tsev Kho Mob tus kheej tau mus ntsib xibfwb Du Ziwei lub tuam tsev saib xyuas cov txheej txheem microsurgical. Yog li ntawd, ib tug nthwv dej ntawm kev taw qhia, kev kawm, thiab kev siv ntawmNeurosurgery microscopestau tshwm sim nyob rau hauv cov chaw kho mob neurosurgery loj hauv Suav teb, cim qhov pib ntawm Tuam Tshoj tus micro neurosurgery.

4 、 Cov nyhuv ntawm Microsurgery phais

Vim yog kev sivneurosurgical microscopes, kev phais uas tsis tuaj yeem ua nrog lub qhov muag liab qab tuaj yeem ua tau nyob rau hauv cov xwm txheej ntawm kev nthuav dav ntawm 6-10 zaug. Piv txwv li, kev phais pituitary qog los ntawm ethmoidal sinus tuaj yeem txheeb xyuas thiab tshem tawm cov qog pituitary thaum tiv thaiv lub qog pituitary; Kev phais uas tsis tuaj yeem ua nrog qhov muag liab qab tuaj yeem dhau los ua kev phais zoo dua, xws li qog nqaij hlav hlwb thiab txha caj qaum intramedullary hlav. Tus kws tshaj lij Wang Zhongcheng muaj qhov kev tuag ntawm 10.7% rau kev phais mob hlwb ua ntej siv cov tshuaj.neurosurgery microscope. Tom qab siv lub tshuab ntsuas tshuab hauv xyoo 1978, cov neeg tuag tau txo qis rau 3.2%. Kev tuag ntawm cov hlab ntsha ntawm lub paj hlwb arteriovenous malformation phais yam tsis siv aphais microscopeyog 6.2%, thiab tom qab xyoo 1984, nrog kev siv aneurosurgery microscopes, tus neeg tuag tau txo mus rau 1.6%. Kev siv ntawmneurosurgery microscopetso cai rau cov qog pituitary tau kho los ntawm kev cuam tshuam me me ntawm transnasal transsphenoidal mus kom ze yam tsis tas yuav tsum tau craniotomy, txo qhov kev phais tuag ntawm 4.7% mus rau 0.9%. Kev ua tiav ntawm cov txiaj ntsig no tsis tuaj yeem ua raws li kev phais qhov muag tag nrho, yog liphais microscopesyog ib lub cim ntawm niaj hnub neurosurgery thiab tau dhau los ua ib qho tseem ceeb thiab tsis tuaj yeem hloov cov khoom siv phais hauv kev kho mob niaj hnub no.