神经外科基本操作.doc

神经外科的基本操作很多,我想建议开展一个交流区,从最小的操作开始,如冲水器的使用,电凝的使用,吸引器使用等这样不经意的动作.请各位战友能积极参与,贴出你的心得体会,以供我等学习之用.这样更利于神外的发展.这是以前一个置顶的帖子，从中学到很多，请大家继续延续我们的交流，以下是gulang100战友整理的一些内容，希望可以节省大家的时间 神经外科的手术经验交流 神外同仁：我把收集的神经外科的手术原则拿出与大家共享，望都有借鉴，为中国外科事业做贡献[color=red]神经外科手术的若干要点Ossama Al-Mefty 著，清风 译1. Remove the bone, leave the brain alone. 尽可能保护脑组织，可能需要更多切除颅骨。2. An arachnoid membrane is your best ally. Always do your dissection within the arachnoidal planes. 蛛网膜是你的朋友，要在蛛网膜间隙分离。3. Microsurgical technique is indispensable in the surgery of meningiomas. Master it. 显微外科技术对于神经外科手术是不可缺少的。4. Sharp dissection is the safest dissection. 锐性分离是最安全的分离。5. Never pull or force anything. Gentle, brother, gentle.尽量减少推压或牵拉脑组织的任何部位。6. The anatomy of the skull base is complex. Learn it in the laboratory before going to the operating room. 颅底解剖很复杂，实验室的学习很重要。7. Seek total removal with zeal during the first operation. It is the patients best chance for cure. The best time is the first time. 在第一次手术中积极寻找完全切除的可能，第一次手术是患者获得治愈的最佳时机。8. The use of the power drill is indispensable. Practice it. 磨钻的使用在神经外科手术中是必不可少的。多进行实践. 9. Be a vascular surgeon: preserve, repair, or reconstruct vessels. Life and function run through them. 做一个血管外科医师,在需要时保护，修复或重建血管。10. Veins are more vital than they are usually believed to be. Preserve them.尽可能保留静脉,静脉比想象的还重要。11. Preserving perforators is the greatest technical challenge and is crucial for preserving function. 保护功能区对神经外科医生是最大的技术挑战。12. Maintain normal cerebral perfusion pressure by avoiding hypotension and cerebral retraction. 维持正常脑灌注压。13. Plan the closure before the opening. 手术前要计划好如何结束。14. Repair defects with vascularized tissue. 修复缺损要用带血管蒂的组织。15. A tumor destroys the normal anatomy. Always be on the lookout for displaced structures. It is better to say there it is and be wrong a hundred times than to say there it was and be right once. 肿瘤会破坏正常解剖关系，要始终留意移位的结构。说错“它在这儿”一百次也比说对“它曾经在这儿”一次要好。 16. Preservation is the best means of reconstruction. Save every structure. 保留是重建的最好方