女性盆底生理上解剖结构的再认识.ppt

历史：公元前2000年，埃及 – 象形文字, Kahoun 文献, “子宫的脱垂”2000年前，希腊 - “倒立振荡(法)”Prolapses were managed with inversion therapy . .PROLAPSES- MIDDLE and DARK AGES欧洲中世纪和愚昧时期 阿拉伯,14世纪 - Avicenna 常见医 学问题，如痔疮。欧洲,15世纪 Jacob Rueff 木刻的解剖图 从古罗马到15世纪的欧洲 – 伽林 (古希腊名医及有关医术的作家) 子宫韧带的解剖; 魔幻/教条“中世纪具有脉管的男性” 内脏的原始图像，反映了科学 发展的停滞 罗马教皇图书馆 HerniaCast ironGirdlesTrusses_______________Pre Plication Era_______________Plication Era_______________Tensioned Repairs_______________Tension Free Mesh1559 17001757180418161877188719531976- 2010Greco Roman EraHippocrates CelsusMiddle and Dark AgesRenaissanceKasper StromayrMattheus PurmannSir Percival PottAstley CooperHesselbachVictorian EraMarion SimsVinzenz von CzernyGeordio Bassini20th CenturyHoward KellyGeorge WhiteEarl ShouldiceIrving Lichenstein.Cullen Richardson.Prolift/Perigee/AvaultaNew MillenniumPelvicolSurgiSIS1850 -1900 -1909 -1982 -1999 -2004 -ProlapseInversionPomegranate&Brass pessariesSilver and Gold pessariesFlexible pessariesVulcanized pessaries_______________Plication EraTensioned Repairs_______________Tension Free Repairs_______________Tension Free MeshBiografts HISTORY- GRECO-ROMAN ERAHernias and prolapse were described by Hippocrates and Celsus but were ill definedThe pathogenesis was not understoodRoman bronze pessary 200 BCScience Museum London希波克拉底: 半个醋浸泡的石榴希腊-罗马时期 带栅栏硬质橡胶子宫托可防止大子宫脱垂从环中疝出；但盆底通常被过度拉伸而无法维持子宫托。Cast iron Girdles Trusses铸铁腰带束（疝带） HISTORY – Hernia [RENAISSANCE]1559 Stromayr ligated the sac of a strangulated hernia and excised the testicle. He defined direct and indirect hernias and dissected the indirect sac.1700 Purmann spared the testicle1757 Sir Percival Pott …. The Pathophysiology of StrangulationCicatrization with acid and cautery to the aponeurosis of external oblique14～16世纪，欧洲文艺复兴时期 HISTORY – Prolapse [RENAISSANCE]Early pessaries.(Stromayr C: Die Handschrift des Schnitt-und Augenarztes Caspar Stromayr. Berlin, Brunn, 1925)Stromayr tightly rolled and bound a sponge with string; dipped it in wax and co