上交大外科学课件01绪论

绪论Introduction of Surgery一、现代外科学的发展 Development of Modern Surgery1.解剖学 AnatomyJohn Hunter(1728-1793)the Englands premier surgical scientist,the father of experimental surgery and a superb anatomist and teacher.2.麻醉 AnesthesiaWillam T.G.Morton(1819-1868),a Boston dentist whose successful demonstration of ether anesthesia on October 16,1846,at the Massachusetts General Hospital was a landmark in the history of surgery3.抗菌术 Antisepesis3.抗菌术抗菌术 AntisepsisJoseph Lister(1827-1912)British scientist,the originator of antiseptic surgery4.输血 Blood transfusionRichard Lewisohn(1875-1961),a surgeon at the Mount Sinai Hospital,introduced the modern technique of blood transfusion,developed from his discovery of a method of preventing coagulation of the blood outside the body.Karl Landsteiner(1868-1943),one of the first scientists to study the physical processes of immunity.He is best known for his identification and characterization of the human blood groups,A,B,and O.The Nobel Prize in Physiology or Medicine 1930 was awarded to Karl Landsteiner for his discovery of human blood groups.Theodor Kocher(1841-1917),professor of surgery at the University of Berne and pioneer in the development of surgery of the 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.Innovators&Pioneers in Surgery文件 文件历史 文件用途 全局文件用途 元数据 John H.Gibbon(1903-1973),pioneer cardiothoracic surgeon who developed extracorporeal circulation.Alexis Carrel(1873-1944)French American surgeon,an experimental surgeon interested in wound healing,tissue culture,organ transplantation,and blood vessel anastomosis.He was awarded the Nobel Prize in 1912.中国古代的外科学扁鹊（公元前500）抢救尸厥（休克）用毒酒麻醉手术华佗（141203）n麻沸散麻醉n死骨剔除术n剖腹术傅培彬(1912-1989),瑞金医院外科创始人现代外科学的里程碑睾丸切除治疗前列腺癌Huggins 1940胃迷走神经切断术Durgstedt 1942胸外心脏按摩Kouwenhoven 1942烧伤复苏Cope-Moore 1942门腔分流和脾肾分流Whipple 1945冠状动脉旁路术Vineberg 1948同种动脉移植Gross 1949人体肾移植Hume 1950心脏起搏器Zoll 1952人工心肺机Gibbon 1953胃泌素瘤Zollinger-Ellison 1954心脏瓣膜置换术Starr-Edwards 1960同种原位肝移植Starzl 1963完全胃肠外营养Dudrick 1968Starzl现代外科诊疗技术的里程碑休克Blaolck-Phemister 1930水电解质Van Slyke 1935ICU和辅助呼吸Hill 1942磁共振显像Bloch 1946介入性放射学Selding 1953高压氧舱Boerema 1956玻璃纤维索内镜 Hirchowitz 1958激光技术Maiman 1960显微外科Jacobson 1960关节置换术Charnley 1971电子计算机断层扫描Hounsfied 1972体外冲击震波Chauussy 1980腹腔镜胆囊切除Mouret 1987Mouret1954 二尖瓣分离 Commissurotomy of mitral stenosis1958 大面积灼伤 Severe Burn1963 断肢再植 Replantation of cut limb1977 肝移植 The 1st case of Liver transplantation 1978 心脏移植 The 1st case of Heart transplantation1990s-交大医学院(原上海第二医科大学)外科全面发展灼伤外科、消化外科、胆胰外科 Burn surg,Digestive S.,P.Biliary口腔外科、整形外科、小儿心脏外科 Stomatological S.Plastic S.Pediatric Cardio S.The role of SJTUSM in the development of surgery in China二、外科学范畴Category of Surgery1.外科疾病分类Classification of Surgical Diseases1)损伤 Trauma mechanical thermal chemical electrical2)感染 Infection3)肿瘤 Neoplasia Benign,Malignant4)畸形 Anatomical abnormalities Congenital,Acquired5)内分泌功能失调 Metabolic&Hormonal disorder6)梗塞与缺血 Infarction&Ischamia7)其它 Others梗阻Obstruction寄生虫病Parasite diseases静脉曲张Vein varicose2.外科专业发展 Development of Surgical Specialties1)工作对象和性质实验外科 Eexperimental Surgery临床外科 Clinical Surgery2)人体解剖系统骨科 Arthrosteopedic surgery颌面外科Dentofacial surgery心胸外科Cardiothoracic surgery泌尿外科Urologic surgery神经外科Neurosurgery普通外科General surgery(腹部外科)Abdominal surgery3)疾病性质 肿瘤外科Neoplastic surgery急症外科Emergency surgery创伤外科Trauma surgery烧伤外科Burn surgery4)手术方式整复外科Plastic surgery显微外科Microsurgery移植外科Transplant surgery微创外科Minimally invasive surgery5)年龄 小儿外科Pediatric Surgery 成人外科Adult Surgery6)专业 妇科Gynecology 耳鼻喉科Otolaryngology 眼科Ophthalmology3.外科总论与各论 General Surgery&Special Surgery 外科学总论 General Surgery 各临床外科共同的专业基础 基础医学与临床外科学的桥梁外科学各论Special Surgery 论述各系统、各脏器 外科疾病的病因、病理、诊断与治疗 外科分子生物学 Surgical molecular biology 外科免疫学 Surgical immunology 无菌术 Aseptic technique 外科水、电解质和酸碱平衡 Fluid and electrolyte management and acid-base balance 输血 Blood transfusion外科休克 Surgical shock外科营养 Surgical nutrition多器官功能障碍综合征Multiple organ dysfunction syndrome,MODS麻醉Anesthesia外科重症监测治疗 Surgical intensive care心肺脑复苏 Brain-cardiopulmonary Resuscitation疼痛治疗 Pain management&Analgesia围手术期处理 Paraoperative management门诊外科 Outpatient surgery外科感染 Surgical infection肿 瘤 Neoplasma创伤 Trauma烧伤与冷伤 Burns&Cold injury显微外科 Microsurgery器官移植 Organ transplantation组织工程 Tissue engineering腔镜外科 Laparoscopic&thorascopic surgery内镜外科 Endoscopic surgery外科介入治疗 Surgical intervention treatment三、如何学习外科How to learn surgery外科医师的职业道德 Moral Character理论联系实践Theory and Practice外科基础Basic theoryBasic knowledgeBasic technique优秀的外科医生需要 CASEC Conceptoncept（观念）（观念）A Anatomynatomy（解剖）（解剖）S Skillkill（技巧）（技巧）E Emergencymergency（应急）（应急）Spunk of tiger 胆大形象化的要求Some figure of speech about the basic demandsEyes of eagle 眼明Hands of women 手巧Heart of mother 心细优秀的外科医生处理好 4个关系 G&GG&G（General&Group）全局观念和团队精神 M&MM&M（Major&Minor）大手术和小手术 Q&QQ&Q（Quantity&Quality）手术质量和数量 E&EE&E（Education&Experience）教育和经验学 问（knowledge,learning&asking)-Learn to find quest