神经外科的手术原则.doc

神经外科的手术原则 Ossama Al-Mefty 著，徐桂兴 译 1. Remove the bone, leave the brain alone. 为尽可能保护脑组织，需要尽可能多的切除颅骨。 2. An arachnoid membrane is your best ally. Always do your dissection within the arachnoidal planes. 蛛网膜是你的朋友，要尽力在蛛网膜间隙分离。 3. Microsurgical technique is indispensable in the surgery of meningiomas. Master it. 显微外科技术对于脑膜瘤手术是不可缺少的，掌握它。 4. Sharp dissection is the safest dissection. 锐性分离是最安全的分离方式。 5. Never pull or force anything. Gentle, brother, gentle. 尽量减少挤压或牵拉脑组织的任何部位，“温柔、温柔、再温柔”。 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. 第一次手术中应积极地追求全切，因为第一次手术是患者获得治愈的最佳时机。第一时机是最佳时机。 8. The use of the power drill is indispensable. Practice it. 磨钻的使用是神经外科手术中是必不可少的。多多练习。. 9. Be a vascular surgeon: preserve, repair, or reconstruct vessels. Life and function run through them. 做一名血管外科医生：,保护、修复或重建血管，因为功能和生命始于此。 10. Veins are more vital than they are usually believed to be. Preserve them., 静脉比你想象中更重要，尽可能保留静脉。 11. Preserving perforators is the greatest technical challenge and is crucial for preserving function. 功能区的保护是神经外科医生最大的技术挑战，对功能的保护至关重要。 12. Maintain normal cerebral perfusion pressure by avoiding hypotension and cerebral retraction. 既要维持正常脑灌注压，又要避免低血压和脑血管收缩。 13. Plan the closure before the opening. 手术前就要计划好结果。 14. Repair defects with vascularized tissue. 修复缺损要用带血管蒂组织。 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，要始终注意移位的结构。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法。尽可能保留每一个结构。 17. Learn from others. It saves you a lot of grief. 多向他人学习，可以使你少走弯路。 18. The little details, to the tail of the last skin suture, are what make the dif