神经外科医生的未来角色:走向融合神经外科医生超越混合神经外科医生

N. Yang
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摘要

随着医学和技术的进步,疾病的治疗方式也在不断发展。因此,医生的角色也发生了变化。由于血管内治疗的进步,专门从事脑血管手术的神经外科医生越来越多地使用血管内技术。因此,同时进行传统开颅、脑血管手术和血管内治疗的所谓“混合神经外科医生”的数量正在增加。这一现象也出现在传统的非手术专科神经内科,使用血管内治疗的神经内科医生也在增加。如今,血管内治疗在神经介入放射学、神经外科和神经病学等医学专业中越来越普遍。在这个时候,神经外科医生应该扮演什么角色?标准化的混合外科医生应该通过治疗出血性中风和缺血性中风为社会做出贡献,保持适当数量的混合神经外科医生以确保满足此类治疗的需求。此外,应该训练更多的神经外科医生来进行复杂的传统手术,因为这些手术是其他人无法完成的。最后,神经外科患者通常需要手术和药物治疗相结合。在这些情况下,一级和二级预防也至关重要。而且,许多神经外科患者也有精神神经症症状。在神经外科背景下,我们,神经外科医生,需要成为重症监护医学的重症医师,住院专家,流行病学家,神经精神病学专家和基础研究人员。因为在我们的医疗环境中,我们必须负责神经外科病人的各种问题。因此,超越混合神经外科医生,开创融合神经外科医生的时代,才是我们未来的角色。(Ewha Med J 2020;43(2):25-28) 2019年12月24日收稿2020年1月30日修稿2020年2月10日收稿
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Future Role of Neurosurgeons: Toward Convergence Neurosurgeon Beyond Hybrid Neurosurgeon
With advances in medicine and technology, treatment modalities for diseases have evolved. Consequently, physicians’ roles have also changed. Because of advances in endovascular treatment, neurosurgeons specializing in cerebrovascular surgery are increasingly using endovascular techniques. Accordingly, the number of so-called “hybrid neurosurgeons” who perform both traditional craniotomy cerebrovascular surgeries and endovascular treatments is on the rise. This phenomenon is also occurring in department of neurology, traditionally a non-surgical specialty, and the number of neurologists using endovascular treatments is also increasing. Nowadays endovascular treatments become more common across medical specialties such as neurointerveional radiology, neurosurgery, and neurology. In this time, what should be the role of neurosurgeons? Standardized hybrid surgeons should contribute to society by treating hemorrhagic stroke and ischemic stroke, maintaining a proper number of hybrid-neurosurgeons to ensure demand for such treatments is met. Further, more neurosurgeons should be trained to perform sophisticated traditional surgeries, as these surgeries cannot be performed by anyone else. Finally, neurosurgery patients often require a combination of surgical and medical treatment. In these situations, primary and secondary prevention are also crucial. And, many neurosurgery patients also have psychoneurotic symptoms. Within neurosurgery backgrounds, we, neurosurgeons, need to be intensivists for critical care medicine, hospitalization experts, epidemiologists, neuropsychiatry experts, and basic researchers. Because we have to be in charge of neurosurgical patients with various problems in our healthcare environment. Therefore, advancing beyond hybrid neurosurgeons and beginning an era of convergence neurosurgeons should be our role in the future. (Ewha Med J 2020;43(2):25-28) Received December 24, 2019 Revised January 30, 2020 Accepted February 10, 2020
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