外科學(xué)緒論

1、一、現(xiàn)代外科學(xué)的發(fā)展,解剖學(xué),John Hunter (1728-1793), Scottish surgeon ，the father of experimental surgery and a superb anatomist and teacher.皇帝內(nèi)經(jīng) -- 血循環(huán),麻醉,Willam t.G. Morton (1819-1868) Boston dentist whose successful demonstrat

2、ion of ether anesthesia on October 16, 1846, at the Massachusetts Gneeral Hospital was a landmark in the history of surgery扁鵲 —— 酒,3. 抗菌術(shù),,上世紀(jì)四十年代 產(chǎn)科醫(yī)生 Semmelweis 博士(1818-1865), 因?yàn)榘l(fā)現(xiàn)了puerperal fever（產(chǎn)褥熱）的病因而被尊稱(chēng)為“母親的

3、救星”, 為了紀(jì)念這一重大成果 , 學(xué)校在1969年改名為 Semmelweis。,德國(guó)醫(yī)生Bergmann —— 蒸汽滅菌1929 英國(guó)Fleming —— 青霉素,輸血 Blood transfusion,Karl Landsteiner (1868-1943), 奧地利病理學(xué)家、美國(guó)免疫學(xué)家，1930年諾貝爾生理學(xué)和醫(yī)學(xué)獎(jiǎng)得主， the human blood groups, A, B, and O.,奧地利 1968.

4、6.14 發(fā)行《病理學(xué)家卡爾 . 蘭德斯泰納誔辰100周年》郵票，一套1枚,Richard Lewisohn (1875-1961) , 德國(guó) 枸櫞酸鈉，血液抗凝,Theodor Kocher (1841-1917), professor of surgery at the University of Berne and pioneer in the development of surgery of the

5、 thyoid. He received the Nobel Prize in 1909.,Theodor Billroth (1829-1894), professor at the University of Vienna and pioneer abdominal surgeon, Billroth was one of the most influential teachers of his time.,John H. Gibb

6、on (1903-1973), 心臟外科，體外循環(huán),Alexis Carrel (1873-1944), 器官移植， He was awarded the Nobel Prize in 1912.,傅培彬 (1912-1989), 瑞金醫(yī)院外科創(chuàng)始人,張金哲首都醫(yī)科大學(xué),1954 二尖瓣分離 Commissurotomy of mitral stenosis1958 大面積灼傷 Severe Burn1963

7、斷肢再植 Replantation of cut limb1977 肝移植 The 1st case of Liver transplantation 1978 心臟移植 The 1st case of Heart transplantation1990s- 灼傷外科、消化外科、膽胰外科 Burn surg, Digestive S., P. Biliary口腔外

8、科、整形外科、小兒心臟外科 Stomatological S. Plastic S. Pediatric Cardio S.,外科的發(fā)展,外科學(xué)范疇,外科疾病分類(lèi) 1) 損傷 Trauma— mechanical thermal chemical electrical……2) 感染 3) 腫瘤 （良性，惡性） 4) 畸形

9、（Congenital, Acquired）,5) 內(nèi)分泌功能失調(diào) ：甲狀腺 6) 其它 梗阻：血管，腸，結(jié)石 寄生蟲(chóng)病靜脈曲張,分類(lèi)：1) 工作對(duì)象和性質(zhì)實(shí)驗(yàn)外科 Eexperimental Surgery臨床外科 Clinical Surgery,2) 人體解剖系統(tǒng)骨科 Arthrosteopedic surgery頜面外科Dentofacial su

10、rgery心胸外科Cardiothoracic surgery泌尿外科Urologic surgery神經(jīng)外科Neurosurgery普通外科General surgery(腹部外科) Abdominal surgery,3) 疾病性質(zhì) 腫瘤外科Neoplastic surgery急癥外科Emergency surgery創(chuàng)傷外科Trauma surgery燒傷外科Burn surg

11、ery4) 手術(shù)方式整復(fù)外科Plastic surgery顯微外科Microsurgery移植外科Transplantation微創(chuàng)外科Minimally invasive surgery,5) 年齡 小兒外科Pediatric Surgery 成人外科Adult Surgery6) 專(zhuān)業(yè) 婦科Gynecology 耳鼻喉科Otolaryngology 眼科

12、Ophthalmology,3. 外科總論與各論,外科學(xué)總論 General Surgery 各臨床外科共同的專(zhuān)業(yè)基礎(chǔ) 基礎(chǔ)醫(yī)學(xué)與臨床外科學(xué)的橋梁外科學(xué)各論Special Surgery 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

13、科免疫學(xué) Surgical immunology● 無(wú)菌術(shù) Aseptic technique● 外科水、電解質(zhì)和酸堿平衡 Fluid and electrolyte management and acid-base balance● 輸血 Blood transfusion,●外科休克Surgical shock●外科營(yíng)養(yǎng)Surgical nutrition●多

14、器官功能障礙綜合征Multiple organ dysfunction syndrome, MODS●麻醉Anesthesia●外科重癥監(jiān)測(cè)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 m

15、anagement●門(mén)診外科Outpatient surgery●外科感染Surgical infection●腫瘤Neoplasma,●創(chuàng)傷Trauma●燒傷與冷傷Burns & Cold injury●顯微外科Microsurgery●器官移植Organ transplantation●組織工程Tissue engineering●腔鏡外科Laparoscopic &a

16、mp; thorascopic surgery●內(nèi)鏡外科Endoscopic surgery●外科介入治療Surgical intervention treatment,如何學(xué)習(xí)外科,●外科醫(yī)師的職業(yè)道德 Moral Character●理論聯(lián)系實(shí)踐Theory and Practice●外科基礎(chǔ)Basic theoryBasic knowledgeBasic technique,Spu

17、nk of tiger — 膽大,形象化的要求Some figure of speech about the basic demands,Eyes of eagle — 眼明,Hands of women — 手巧,Heart of mother — 心細(xì),學(xué) 問(wèn)- Learn to find questions- Learn to ask questions- Learn to solve questions