外科学教学课件：1.1外科学绪论.ppt

外科学绪论Introduction of Surgery一、现代外科学的发展 Development of Modern Surgery1.解剖学 AnatomyJohn Hunter (1728-1793) the England’s 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 surgery3.抗菌术 Antisepesis3. 抗菌术抗菌术 AntisepsisJoseph Lister (1827-1912)British scientist, the originator of antiseptic surgery4.输血 Blood transfusionRichard Lewisohn (1875-1961), 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 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) 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 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（141－203）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 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－ 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 1987Mouret1954 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 electrical……2) 感染 Infection3) 肿瘤 Neoplasia Benign, Malignant4) 畸形 Anatomical abnormalities Congenital, Acquired5) 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 varicose2. 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 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 surgery5) 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Ophthalmology3. 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● 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 Basic theory Basic knowledgeBasic technique优秀的外科医生需要 CASE•C 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 & & 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 questions- Learn to ask questions- Learn to solve questions Books are your best teachersLibrary is your best school Facing to the patients Emphasizing the clinical practice结束语Now, you may have a good start- why to learn- how to learnWell begun, half done.良好的开端，成功的一半。

目标已明，努力干吧！。