外科学教学课件：外科学绪论

1、外科学绪论 Introduction of Surgery,一、现代外科学的发展 Development of Modern Surgery,解剖学 Anatomy,John Hunter (1728-1793) the Englands premier surgical scientist, the father of experimental surgery and a superb anatomist and teacher,麻醉 Anesthesia,Willam T.G. Morton (1819-1868), a Boston dentist whose successful de

2、monstration of ether anesthesia on October 16, 1846, at the Massachusetts General Hospital was a landmark in the history of surgery,3.抗菌术 Antisepesis,3. 抗菌术 Antisepsis,Joseph Lister (1827-1912) British scientist, the originator of antiseptic surgery,输血 Blood transfusion,Richard Lewisohn (1875-1961),

3、 a German 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), an Austrian doctor, one of the first scientists to study the physical pr

4、ocesses 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 Uni

5、versity 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 Surg

6、ery,文件 文件历史 文件用途 全局文件用途 元数据,John H. Gibbon (1903-1973) an American surgeon , cardiothoracic surgery pioneer who developed extracorporeal circulation,Alexis Carrel (1873-1944) French American surgeon, an experimental surgeon interested in wound healing, tissue culture, organ transplantation, and bloo

7、d 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） 麻沸散麻醉 死骨剔除术 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

8、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 1968,Starzl,现代外科诊疗技术的里程碑,休克Blaolck-Phemister 1930 水电解质Van Slyke 1935 ICU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 Hirchowi

9、tz 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 1987,Mouret,1954 二尖瓣分离 Commissurotomy of mitral stenosis 1958 大面积灼伤 Severe Burn 1963 断肢再植 Replantation of cut limb 1977 肝移植 The 1st case of Liver transplantation 1978 心脏移植 The 1st c

10、ase of Heart transplantation 1990s- 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 Surgery,外科疾病分类 Classification of Surgical Diseas

11、es 1) 损伤 Trauma mechanical thermal chemical electrical 2) 感染 Infection 3) 肿瘤 Neoplasia Benign, Malignant 4) 畸形 Anatomical abnormalities Congenital, Acquired,5) 内分泌功能失调 Metabolic & Hormonal disorder 6) 梗塞与缺血 Infarction & Ischamia 7) 其它 Others 梗阻Obstruction 寄生虫病Parasite diseases 静脉曲张Vein varicose,2. 外

12、科专业发展 Development of Surgical Specialties,工作对象和性质 实验外科 Eexperimental Surgery 临床外科 Clinical Surgery,2) 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 surgery,3) 疾病性质 肿瘤外科Neoplastic surgery

13、 急症外科Emergency surgery 创伤外科Trauma surgery 烧伤外科Burn surgery 4) 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 surgery,5) 年龄 小儿外科Pediatric Surgery 成人外科Adult Surgery 6) 专业 妇科Gynecology 耳鼻喉科Otolaryngology 眼科Ophthalmology,3. 外科总论与各论 General Surgery & Special Surge

14、ry,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Surgi

15、cal 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 Bu

16、rns & 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 机器人手术 Robotic surgery,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 B

17、asic theory Basic knowledge Basic technique,优秀的外科医生需要 CASE,Concept（观念） Anatomy（解剖） Skill（技巧） Emergency（应急,Spunk of tiger 胆大,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 心细,优秀的外科医生处理好 4个关系,G & G（General & Group） 全局观念和团队精神 M & M（Major & Minor） 大手术和小手术 Q & Q（Quantity & Quality） 手术质量和数量 E & E（Education & Experience） 教育和经验,学 问（knowledge, learning & asking ) - Learn to find questions -