外科学总论ppt课件[文字可编辑]

结语
? 要想学好外科，必须勤奋学习，刻苦钻 研，努力实践
? 要想成为一名好医师,必须具有扎实的基 础知识，基础理论和熟练操作技能
? 要想成为一位名医，除了具备一名好医 师的条件外，还应具有高尚的医德
? 现代外科奠基于19世纪40年代
? 手术疼痛 ,伤口感染,止血和输血是当时 外科难题。
? Louis Pasteur 的细菌学理论是19世纪生 物界对医学界最大贡献
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 knowledge
Basic technique
形象化的要求 Some figure of speech about the basic demands
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
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
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.
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
2. 麻醉 Anesthesia
Willam t.G. Morton (1819-1868), a Boston dentist whose successful demonstration of ether anesthesia on October 16, 1846, at the Massachusetts Gneeral Hospital was a landmark in the history of 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) 性病性质 肿瘤外科 急症外科 创伤外科 烧伤外科
4) 手术方式 整复外科 显微外科 移植外科 微创外科
Neoplastic surgery Emergency surgery Trauma surgery Burn surgery
Spunk of tiger — 胆大
Eyes of eagle — 眼明
Hands of women — 手巧
Heart of mother — 心细
学问
- Learn to find questions - Learn to ask questions - Learn to solve questions
John H. Gibbon (1903-1973), pioneer cardiothoracic surgeon who developed extracorporeal circulation.
Alexis Carrel (1873-1944), an experimental surgeon interested in wound healing, tissue culture, organ transplantation, and blood vessel anastomosis. He was awarded the Nobel Prize in 1912.
3. 抗菌术 Antisepsis
Joseph Lister (18271912), the originator of antiseptic surgery
4. 输血 Blood transfusion
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.
1) 损伤 Trauma — mechanical thermal chemical electrical……
2) 感染 Infection 3) 肿瘤 Neoplasia Benign, alignant 4) 畸形 Anatomical abnormalities
Congenital, Acquired
? Morton首先用乙醚麻醉帮助Warren手术
? Semmelweis在1846年首先提出用漂白粉 洗手使产妇死亡率由10%-1%
? Lister(1867)用石炭酸消毒 奠定了抗菌术 的基本原则
能力
三、重视三基：“基本知识、基 本技能、基本理论”
? 基本知识— 基础医学知识和其他各学科 的知识
? 基本技能— 医疗文书的书写、无菌观念、
消毒方法、外科切开、分离、止血、结
扎、缝合、引流、换药等操作
? 基本理论—运用前期所学的知识帮助在
临床实践中加深理解，加深认识，决不
能只
“知其然，不知所以
然”
Specialties
1) 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
怎样学习外科学
? 一、充分认识医生的基础职责 是解决医疗、预防工作的实际问题，为人
民的健康服务 从技术上外科医生应由三部分组成“三个
三分之一” ? 术前的诊断和术前准备 ? 手术操作 ? 术后的处理
二、理论和实践相结合
? 书本知识要扎实 ? 积极参加临床实践 ? 感性知识和理性认识紧密结合 ? 提高发现问题，分析问题和解决问题的
Innovators & Pioneers in Surgery
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.
●围手术期处理
Perioperative management
●门诊外科 ●外科感染 ●肿瘤
Outpatient surgery Surgical infection Neoplasma
●Hale Waihona Puke 伤Trauma●烧伤与冷伤
Burns & Cold injury
●显微外科
Microsurgery
●器官移植
5) 内分泌功能失调 Metabolic &
Hormonal disorder
6) 梗塞与缺血 Infarction & Ischami
7) 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
傅培彬 (1912-1989), 瑞金医院外科创始人
The role of SSMU in the development of surgery in China
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 1 st case of Liver transplantation 1978 心脏移植 The 1st case of Heart transplantation 1990s- 二医外科全面发展
? Edward Jenner(18 世纪末)发现smallpox vaccine
一、现代外科学的发展
Development of Modern Surgery
1. 解剖学 Anatomy
John Hunter (1728-1793), the father of experimental surgery and a superb anatomist and teacher.
– 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.
二、外科学范畴 Category of Surgery
1. 外科疾病分类 Classification of Surgical Diseases
Richard 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.
● 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
外科学总论
?
医学史
? Hippocrates( 公圆前460-370)has been recognized as the father of modern medicine
? Aristotle(BC270-?)has been called the father of biology
? William Harvey(17 世纪)阐明了血液循环机制
Books are your best teachers Library is your best school
Now, you may have a good start - why to learn - how to learn
Well begun, half done. 良好的开端，成功的一半。 目标已明，努力干吧！
Plastic surgery Microsurgery Transplantation Minimally invasive surgery
5) 年龄 小儿外科 成人外科
6) 专业 妇科 耳鼻喉科 眼科
Pediatric Surgery Adult Surgery
Gynecology Otolaryngology Ophthalmology