Amateka y'ikoreshwa n'uruhare rwa mikorosikopi zo kubaga mu kubaga ubwonko

 

Mu mateka y'ubuvuzi bw'imitsi, ikoreshwa ryamikorosikopi zo kubagani ikimenyetso cy'ingenzi, kiva mu gihe gakondo cyo kubaga imitsi yo mu bwonko cyo kubaga imbere y'amaso kugera mu gihe cya none cyo kubaga imitsi yo mu bwonko munsi y'uburyomikorosikopiNi nde kandi ryari yabikozemikorosikopi zikoraitangira gukoreshwa mu kubaga ubwonko? Ni uruhe ruhare yagizemikorosikopi yo kubagabyagize uruhare mu iterambere ry'ubuvuzi bw'imitsi? Hamwe n'iterambere rya siyansi n'ikoranabuhanga, eseMikorosikopi ikoragusimbuzwa ibikoresho bigezweho? Iki ni ikibazo buri muganga w’imitsi agomba kumenya no gukoresha ikoranabuhanga rigezweho mu bijyanye no kubaga ubwonko, bigateza imbere ubumenyi mu kubaga ubwonko.

1. Amateka y'ikoreshwa rya mikorosikopu mu rwego rw'ubuvuzi

Muri fiziki, indorerwamo z'indorerwamo ni indorerwamo z'indorerwamo zifite imiterere imwe ifite ubushobozi bwo gukuraho ibintu, kandi ubwiza bwazo ni buke, buzwi nka indorerwamo z'indorerwamo. Mu 1590, Abaholandi babiri bashyize amabara abiri y'indorerwamo z'indorerwamo z'indorerwamo mu mwenda muto w'uruziga, bityo bavumbura igikoresho cya mbere ku isi cyo gukuraho ibintu:mikorosikopiNyuma yaho, imiterere ya mikorosikopi yakomeje kunozwa, kandi ubwiyongere bw'ishusho bwakomeje kwiyongera. Icyo gihe, abahanga mu bya siyansi bakoreshaga cyane iyimikorosikopi y'ibice byinshikwitegereza imiterere mito y’inyamaswa n’ibimera, nk’imiterere y’uturemangingo. Kuva hagati mu kinyejana cya 19 kugeza mu mpera zacyo, indorerwamo zo gukuza no gukoresha mikorosikopi byagiye bikoreshwa buhoro buhoro mu rwego rw’ubuvuzi. Mbere na mbere, abaganga b’inzobere mu kubaga bakoresheje indorerwamo zo gukuza zifite imiterere imwe y’indorerwamo yashoboraga gushyirwa ku kiraro cy’izuru mu kubaga. Mu 1876, umuganga w’Umudage Saemisch yakoze igikorwa cya mbere cyo kubaga "mikorosikopi" ku isi akoresheje indorerwamo zo gukuza indorerwamo (ubwoko bw’uburyo bwo kubaga ntibuzwi). Mu 1893, isosiyete yo mu Budage ya Zeiss yavumbuye icyo gikorwa.mikorosikopi y'indorerwamo, ikoreshwa cyane cyane mu gusuzuma igerageza muri laboratwari z'ubuvuzi, ndetse no mu gusuzuma ibisebe byo mu cyumba cy'amaso n'iby'imbere mu rwego rw'amaso. Mu 1921, hashingiwe ku bushakashatsi bwa laboratwari ku miterere y'amatwi y'inyamaswa, umuhanga mu by'amaso wo muri Suwede witwa Nylen yakoresheje uburyo bwo gusuzuma buhamyemikorosikopi imwe yo kubagaYakozwe na we ubwe kugira ngo abage abantu indwara idakira ya otitis media, ibyo bikaba byari igikorwa cy’ukuri cyo kubaga mikorosikopi. Nyuma y’umwaka umwe, umuganga mukuru wa Nylen Hlolmgren yatangije uburyo bwo kubaga abantumikorosikopi yo kubaga imbonankubonebyakozwe na Zeiss mu cyumba cyo kubaga.

Igihe cya mbereMikorosikopi zikorayari ifite imbogamizi nyinshi, nko kudakomera neza mu byuma, kudashobora kugenda, kumurika imirasire itandukanye no gushyushya indorerwamo, ubushobozi bwo kwagura ibikoresho byo kubaga, nibindi. Izi zose ni impamvu zigabanya ikoreshwa ryagutse ryamikorosikopi zo kubagaMu myaka mirongo itatu yakurikiyeho, bitewe n'imikoranire myiza hagati y'abaganga b'inzobere mu kubaga n'abakora mikorosikopi, imikorere yamikorosikopi zo kubagayakomeje kunozwa, kandimikorosikopi zo kubaga ikoranabuhanga rya "binocular", mikorosikopi zishyirwa ku gisenge, lenzi zoom, urumuri rwa coaxial, amaboko acungwa n'amashanyarazi cyangwa amazi, uburyo bwo kugenzura ibirenge, n'ibindi byakozwe buhoro buhoro. Mu 1953, isosiyete yo mu Budage ya Zeiss yakoze urukurikirane rw'ibikoresho byihariyemikorosikopi zo kubaga mu bijyanye n'amaso, cyane cyane ikwiriye kubagwa ku bisebe byimbitse nk'amagufwa yo hagati n'igufwa ry'igihe. Mu gihe imikorere yamikorosikopi zo kubagabikomeje gutera imbere, imyumvire y'abaganga b'inzobere mu kubaga nayo ihora ihinduka. Urugero, abaganga b'Abadage Zollner na Wullstein bavuze komikorosikopi zo kubagaigomba gukoreshwa mu kubaga imiterere y'uruti rw'amaso. Kuva mu myaka ya 1950, abaganga b'amaso bagiye bahindura buhoro buhoro uburyo bwo gukoresha mikorosikopi gusa mu gusuzuma amaso kandi bashyiramomikorosikopi zo kubaga za otosurgicalmu kubagwa amaso. Kuva icyo gihe,Mikorosikopi ikorabyakoreshejwe cyane mu bijyanye n'ubuvuzi bw'amaso n'ubuvuzi bw'amaso.

2. Gukoresha mikorosikopi yo kubaga mu kubaga ubwonko

Bitewe n'umwihariko w'ubuvuzi bw'imitsi, ikoreshwa ryamikorosikopi yo kubaga mu kubaga ubwonkonyuma gato y’ubuvuzi bw’amaso n’amaso, kandi abaganga b’imitsi barimo kwiga ubu buryo bushya. Icyo gihe,gukoresha mikorosikopi zo kubagabyari mu Burayi cyane cyane. Umuganga w'amaso w'Umunyamerika Perrit yabanje kugaragazwamikorosikopi zo kubagakuva i Burayi kugera muri Leta Zunze Ubumwe za Amerika mu 1946, bishyiraho urufatiro rw'abaganga b'imitsi b'Abanyamerika bakoreshaMikorosikopi zikora.

Mu rwego rwo kubahiriza agaciro k'ubuzima bw'umuntu, ikoranabuhanga rishya, ibikoresho, cyangwa ibikoresho bikoreshwa ku mubiri w'umuntu bigomba kugeragezwa mbere y'inyamaswa no gutozwa tekiniki ku bakora. Mu 1955, umuganga w'indwara z'imitsi w'umunyamerika witwa Malis yabaze ubwonko inyamaswa akoreshejemikorosikopi yo kubaga imbonankuboneKurze, umuganga w’indwara z’ubwonko muri Kaminuza ya Southern California muri Leta Zunze Ubumwe za Amerika, yamaze umwaka yiga uburyo bwo kubaga hakoreshejwe mikorosikopi muri laboratwari nyuma yo kubaga ugutwi akoresheje mikorosikopi. Muri Kanama 1957, yakoze neza igikorwa cyo kubaga neuroma y’amajwi ku mwana w’imyaka 5 akoreshejemikorosikopi yo kubaga ugutwi, ari nabwo bwa mbere ku isi bwakorewe kubaga mikorosikopi. Nyuma gato, Kurze yakoze neza uburyo bwo gupima imitsi yo mu maso ku mwana akoresheje uburyo bwo kubaga mikorosikopi.mikorosikopi yo kubaga, kandi umwana yakize neza cyane. Iyi yari ubuvuzi bwa kabiri bwo kubaga hakoreshejwe microsurgical ku isi. Nyuma yaho, Kurze yakoresheje amakamyo mu gutwaraMikorosikopi zikoraahantu hatandukanye ho kubaga indwara z'ubwonko hakoreshejwe microsurgical neurosurgery, kandi yasabye cyane ikoreshwa ryamikorosikopi zo kubagaku bandi baganga b'imitsi. Nyuma yaho, Kurze yakoze operation yo gukata imitsi yo mu bwonko akoresheje uburyo bwamikorosikopi yo kubaga(ikibabaje ni uko nta nkuru yigeze asohora). Afashijwe n'umurwayi w'indwara zo mu bwonko za trigeminal yavuje, yashinze laboratwari ya mbere ku isi yo kubaga indwara zo mu bwonko mu mutwe mu 1961. Tugomba kwibuka uruhare rwa Kurze mu kubaga indwara zo mu bwonko no kwigira ku butwari bwe bwo kwemera ikoranabuhanga n'ibitekerezo bishya. Ariko, kugeza mu ntangiriro za 1990, bamwe mu baganga b'indwara zo mu bwonko mu Bushinwa ntibemeyeMikorosikopi zo kubaga ubwonkokubagwa. Iki ntabwo cyari ikibazo kuriMikorosikopi yo kubaga ubwonkoubwabyo, ariko ikibazo kiri mu gusobanukirwa ibitekerezo by'abaganga b'imitsi.

Mu 1958, umuganga w’imitsi w’umunyamerika Donaghy yashinze laboratwari ya mbere ku isi y’ubushakashatsi n’amahugurwa ku kubaga mikorosikopi i Burlington, muri Vermont. Mu ntangiriro, yanahuye n’urujijo n’ibibazo by’amafaranga bivuye ku bayobozi be. Mu mashuri makuru, yahoraga yibwira ko yacaga imiyoboro y’amaraso yo mu bwoko bwa cortical kugira ngo akuremo thrombi mu barwayi bafite thrombosis yo mu bwonko. Bityo yakoranye n’umuganga w’imitsi Jacobson mu bushakashatsi ku nyamaswa no ku buvuzi. Icyo gihe, mu gihe cy’amaso y’umuntu utabona, imiyoboro mito y’amaraso ifite umurambararo wa milimetero 7-8 cyangwa irenga ni yo yashoboraga gukururwa. Kugira ngo imiyoboro y’amaraso mito igere ku yindi igere ku yindi, Jacobson yagerageje kubanza gukoresha ikirahuri cyo gukuza indorerwamo. Nyuma gato, yibutse ko yakoresheje ikirahuri cyo gukuza indorerwamo.mikorosikopi yo kubaga ya otolaryngologykubagwa ubwo yari umuganga usanzwe. Rero, abifashijwemo na Zeiss mu Budage, Jacobson yakoze mikorosikopi y'abaganga babiri (Diploscope) ku bijyanye no kubaga imitsi, bituma abaganga babiri babagwa icyarimwe. Nyuma y'igerageza rikomeye ku nyamaswa, Jacobson yasohoye inkuru ku kubaga imbwa n'imitsi idakoresha imiti ya carotid (1960), ifite igipimo cya 100% cy'uko imitsi ya kanseri y'imitsi ihagaze. Iyi ni inyandiko y'ubuvuzi ijyanye no kubaga imitsi no kubaga imitsi. Jacobson yanakoze ibikoresho byinshi byo kubaga, nk'imikasi mito, udukoresho duto two gufata inshinge, n'imishumi y'ibikoresho bito. Mu 1960, Donaghy yakoze neza igikorwa cyo kubaga imitsi yo mu bwonko hakoreshejwe uburyo bwa "thrombectomy" munsi ya "ambulance".mikorosikopi yo kubagaku murwayi ufite thrombosis yo mu bwonko. Rhoton wo muri Leta Zunze Ubumwe za Amerika yatangiye kwiga imiterere y'ubwonko akoresheje mikorosikopi mu 1967, atangira ishami rishya ry'imiterere y'umubiri w'umuntu uvura indwara zo mu bwonko, anatanga umusanzu ukomeye mu iterambere ry'ubuvuzi bwo mu bwonko. Bitewe n'ibyiza byomikorosikopi zo kubagano kunoza ibikoresho byo kubaga bikozwe muri mikorosikopi, abaganga benshi bakunda gukoreshamikorosikopi zo kubagayo kubaga. Kandi yasohoye ingingo nyinshi zijyanye nayo ku buryo bwo kubaga mikorosikopi.

3. Gukoresha mikorosikopi yo kubaga mu kubaga ubwonko mu Bushinwa

Nk'umushinwa ukunda igihugu cye mu mahanga mu Buyapani, Porofeseri Du Ziwei yatanze impano ya mbere y'umutungo wo mu gihugu imberemikorosikopi yo kubaga ubwonkon'ibifitanye isanoibikoresho byo kubaga mikorosikopimu Ishami ry’Ubuvuzi bw’Ubwonko rya Suzhou Medical College Affiliated Hospital (ubu ni Ishami ry’Ubuvuzi bw’Ubwonko rya Suzhou University Affiliated First Hospital) mu 1972. Nyuma yo kugaruka mu Bushinwa, yakoze bwa mbere kubaga mikorosikopi nka aneurysms zo mu mutwe na meningiomas. Nyuma yo kumenya uko byaboneka.mikorosikopi zo kubaga ubwonkon'ibikoresho byo kubaga mikorosikopi, Porofeseri Zhao Yadu wo mu ishami ry'ubuvuzi bw'imitsi mu bitaro bya Beijing Yiwu yasuye Porofeseri Du Ziwei wo muri Suzhou Medical College kugira ngo yirebere ikoreshwa ryamikorosikopi zo kubagaPorofeseri Shi Yuquan wo mu bitaro bya Shanghai Huashan yasuye ishami rya Porofeseri Du Ziwei ubwe kugira ngo yirebere uburyo bwo kubaga hakoreshejwe micro-bagie. Kubera iyo mpamvu, habayeho uburyo bwo gutangiza, kwiga no gushyira mu bikorwaMikorosikopi zo kubaga ubwonkobyatangiye mu bigo bikomeye byo kubaga indwara z'ubwonko mu Bushinwa, bikaba byaratangiye igikorwa cyo kubaga indwara z'ubwonko mu Bushinwa.

4. Ingaruka zo kubaga mikorosikopi

Bitewe n'ikoreshwa ryamikorosikopi zo kubaga ubwonkoKubaga bidashobora gukorwa n'amaso yambaye ubusa biba bishoboka iyo bikozwe mu buryo bwo kongera inshuro 6-10. Urugero, kubaga ikibyimba cya pituitary binyuze muri sinus ya ethmoidal bishobora kumenya no gukuraho ibibyimba bya pituitary mu buryo bwizewe ariko bikanarinda ingirabuzimafatizo isanzwe ya pituitary; kubaga bidashobora gukorwa n'amaso yambaye ubusa bishobora kuba kubaga neza, nk'ibibyimba byo mu bwonko n'ibibyimba byo mu mugongo. Inzobere mu by'amashuri makuru Wang Zhongcheng yari afite igipimo cy'impfu cya 10.7% kubera kubaga aneurysm yo mu bwonko mbere yo gukoresha uburyo bwa """mikorosikopi yo kubaga ubwonkoNyuma yo gukoresha mikorosikopi mu 1978, igipimo cy'impfu cyaragabanutse kigera kuri 3.2%. Igipimo cy'impfu ziterwa no kubagwa imitsi yo mu bwonko hadakoreshejwe uburyo bwo kuvura indwara.mikorosikopi yo kubagayari 6.2%, kandi nyuma ya 1984, hakoreshejwe uburyo bwamikorosikopi z'ubuvuzi bw'imitsi, igipimo cy'impfu cyagabanutse kigera kuri 1.6%. Ikoreshwa ryamikorosikopi yo kubaga ubwonkoyemerera ibibyimba byo mu bwonko kuvurwa hakoreshejwe uburyo bworoshye bwo gupima ububabare bw'amaso bukoresheje transsphenoidal butabangamira cyane hatabayeho gukorerwa craniotomy, bigabanya igipimo cy'impfu zo kubagwa kuva kuri 4.7% kugeza kuri 0.9%. Kugera kuri ibi bisubizo ntibishoboka mu gihe cyo kubaga amaso mu buryo busanzwe, bityomikorosikopi zo kubagani ikimenyetso cy'ubuvuzi bw'imitsi bugezweho kandi bwabaye kimwe mu bikoresho by'ingenzi kandi bidasimburwa mu buvuzi bw'imitsi bugezweho.