外科學(xué)總論1緒論

外科學(xué)緒論Introduction

of

Surgery一、現(xiàn)代外科學(xué)的發(fā)展Development

of

Modern

Surgery1.

解剖學(xué)AnatomyJohnHunter

(1728-1793) theEngland’spremier

surgical

scientist,

the

father

ofexperimental

surgery

and

asuperbanatomist

andteacher.2.

麻醉AnesthesiaWillam

T.G.

Morton

(1819-1868),

aBoston

dentist

whose

successfuldemonstration

of

ether

anesthesia

onOctober

16,

1846,

at

the

MassachusettsGeneral

Hospital

wasa

landmark

in

thehistory

of

surgery3.抗菌術(shù)Antisepesis3.

抗菌術(shù)AntisepsisJoseph

Lister

(1827-1912)British

scientist,the

originator

of

antisepticsurgery4.

輸血

Blood

transfusionRichard

Lewisohn

(1875-1961),

a

surgeon

atthe

Mount

Sinai

Hospital,

introduced

themodern

technique

of

blood

transfusion,developed

from

his

discovery

of

a

method

ofpreventing

coagulation

of

the

blood

outsidethe

body.Karl

Landsteiner

(1868-1943),

one

of

the

firstscientists

to

study

the

physical

processes

ofimmunity.

He

is

best

known

for

his

identificationand

characterization

of

the

human

blood

groups,

A,B,

and

O.

The

Nobel

Prize

in

Physiology

or

Medicine

1930

was

awarded

to

Karl

Landsteiner

forhis

discovery

of

human

blood

groups.Theodor

Kocher

(1841-1917),

professor

of

surgeryat

the

University

of

Berne

and

pioneer

inthedevelopment

of

surgery

of

the

thyoid.

He

receivedthe

Nobel

Prize

in1909.Theodor

Billroth

(1829-1894),

professor

attheUniversity

of

Vienna

and

pioneer

abdominal

surgeon,Billroth

was

one

of

the

most

influential

teachers

of

his

time.Innovators

&

Pioneers

in

Surgery全局文件用途元數(shù)據(jù)John

H.

Gibbon

(1903-1973),

pioneercardiothoracic

surgeon

who

developedextracorporeal

circulation.Alexis

Carrel

(1873-1944)

FrenchAmerican

surgeon,

an

experimentalsurgeon

interested

in

wound

healing,

tissueculture,

organ

transplantation,

and

bloodvessel

anastomosis.

He

was

awarded

theNobel

Prize

in

1912.中國古代的外科學(xué)扁鵲（公元前500）搶救尸厥（休克）用毒酒麻醉手術(shù)華佗（141－203）麻沸散麻醉死骨剔除術(shù)剖腹術(shù)傅培彬(1912-1989),瑞金醫(yī)院外科創(chuàng)始人現(xiàn)代外科學(xué)的里程碑睪丸切除治療前列腺癌－Huggins1940胃迷走神經(jīng)切斷術(shù)－Durgstedt1942胸外心臟按摩－Kouwenhoven

1942燒傷復(fù)蘇－Cope-Moore1942門腔分流和脾腎分流－Whipple1945冠狀動脈旁路術(shù)－Vineberg1948同種動脈移植－Gross1949人體腎移植－Hume1950心臟起搏器－Zoll1952人工心肺機(jī)－Gibbon1953胃泌素瘤－Zollinger-Ellison

1954心臟瓣膜置換術(shù)－Starr-Edwards

1960同種原位肝移植－Starzl1963完全胃腸外營養(yǎng)－Dudrick

1968Starzl現(xiàn)代外科診療技術(shù)的里程碑休克－Blaolck-Phemister

1930水電解質(zhì)－Van

Slyke

1935ICU和輔助呼吸－Hill1942磁共振顯像－Bloch

1946介入性放射學(xué)－Selding1953高壓氧艙－Boerema1956玻璃纖維索內(nèi)鏡－Hirchowitz1958激光技術(shù)－Maiman1960顯微外科－Jacobson

1960關(guān)節(jié)置換術(shù)－Charnley1971電子計算機(jī)斷層掃描－Hounsfied1972體外沖擊震波－Chauussy1980腹腔鏡膽囊切除－Mouret1987Mouret1954

二尖瓣分離

Commissurotomy

of

mitral

stenosis1958

大面積灼傷

Severe

Burn1963

斷肢再植1977

肝移植1978

心臟移植Replantation

of

cut

limbThe

1st

case

of

Liver

transplantationThe

1st

case

of

Heart

transplantation1990s-

交大醫(yī)學(xué)院(原上海第二醫(yī)科大學(xué))外科全面發(fā)展灼傷外科、消化外科、膽胰外科Burn

surg,

Digestive

S.,

P.

Biliary口腔外科、整形外科、小兒心臟外科Stomatological

S.

Plastic

S.

Pediatric

Cardio

S.The

roleof

SJTUSMin

thedevelopmentof

surgery

in

China二、外科學(xué)范疇Category

ofSurgery1.

外科疾病分類Classification

of

Surgical

Diseases1)損傷Trauma—

mechanicalchemicalInfectionNeoplasiathermalelectrical……Benign,

Malignant感染腫瘤畸形Anatomical

abnormalitiesCongenital,

Acquired內(nèi)分泌功能失調(diào)Metabolic

&

Hormonal

disorder梗塞與缺血

Infarction

&

Ischamia其它

OthersObstruction梗阻寄生蟲病

Parasite

diseases靜脈曲張Vein

varicose2.

外科專業(yè)發(fā)展Development

of

Surgical

Specialties1)

工作對象和性質(zhì)實驗外科

Eexperimental

Surgery臨床外科

Clinical

Surgery2)人體解剖系統(tǒng)骨科頜面外科心胸外科泌尿外科神經(jīng)外科普通外科(腹部外科)Arthrosteopedic

surgeryDentofacial

surgeryCardiothoracic

surgeryUrologic

surgeryNeurosurgeryGeneral

surgeryAbdominal

surgeryNeoplastic

surgeryEmergency

surgeryTrauma

surgeryBurn

surgery疾病性質(zhì) 腫瘤外科 急癥外科 創(chuàng)傷外科 燒傷外科手術(shù)方式整復(fù)外科顯微外科移植外科微創(chuàng)外科Plastic

surgeryMicrosurgeryTransplant

surgeryMinimally

invasive

surgeryPediatric

SurgeryAdult

Surgery年齡小兒外科成人外科專業(yè)婦科耳鼻喉科眼科GynecologyOtolaryngologyOphthalmology3.

外科總論與各論General

Surgery

&

Special

Surgery外科學(xué)總論

General

Surgery各臨床外科共同的專業(yè)基礎(chǔ)

基礎(chǔ)醫(yī)學(xué)與臨床外科學(xué)的橋梁Special

Surgery外科學(xué)各論論述各系統(tǒng)、各臟器外科疾病的病因、病理、診斷與治療外科分子生物學(xué)Surgical

molecular

biology外科免疫學(xué)Surgical

immunology無菌術(shù)Aseptic

technique外科水、電解質(zhì)和酸堿平衡Fluid

and

electrolyte

managementand

acid-base

balance輸血

Blood

transfusion外科休克Surgical

shock外科營養(yǎng)Surgical

nutrition多器官功能障礙綜合征Multiple

organ

dysfunction

syndrome,

MODS麻醉

Anesthesia外科重癥監(jiān)測治療

Surgical

intensive

care心肺腦復(fù)蘇Brain-cardiopulmonary

Resuscitation疼痛治療Pain

management

&

Analgesia圍手術(shù)期處理Paraoperative

management門診外科外科感染腫瘤Outpatient

surgerySurgical

infectionNeoplasma創(chuàng)傷燒傷與冷傷顯微外科器官移植組織工程腔鏡外科內(nèi)鏡外科外科介入治療TraumaBurns

&

Cold

injuryMicrosurgeryOrgan

transplantationTissue

engineeringLaparoscopic

&

thorascopic

surgeryEndoscopic

surgerySurgical

intervention

treatment三、如何學(xué)習(xí)外科How

to

learnsurgery外科醫(yī)師的職業(yè)道德

Moral

Character理論聯(lián)系實踐外科基礎(chǔ)Theory

and

PracticeBasic

theoryBasic

knowledgeBasic

technique優(yōu)秀的外科醫(yī)生需要

CASEConcept（觀念）Anatomy（解剖）Skill（技巧）Emergency（應(yīng)急）Spunk

of

tiger—膽大形象化的要求Some

figure

of

speech

about

the

basic

demandsEyes

of

eag