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显微镜的使用及注意事项

2019-10-15 08:48| 发布者: admin| 查看: 89| 评论: 0

摘要: 【前言】《The Practice of Surgical Pathology》一书是病理诊断的入门指南,为了让大家无伤害使用显微镜,笔者对其内容进行翻译如下(中英文对照)。在看中英文之前,先讲个小故事。苏东坡先生来庐山游玩时,碰到了 ...


【前言】《The Practice of Surgical Pathology》一书是病理诊断的入门指南,为了让大家无伤害使用显微镜,笔者对其内容进行翻译如下(中英文对照)。在看中英文之前,先讲个小故事。苏东坡先生来庐山游玩时,碰到了一位病理医生,两人交谈后,即兴作诗一首:横看成岭侧成峰,远近高低各不同。不识庐山真面目,只缘身在此山中。

东坡先生说:和你见面就是有缘,今日庐山所见和你专业相近,把这首诗送给你。当时,这位病理医生不知道此诗的真正含义。有一次请老师看镜下切片时,老师说:淋巴结首先要从低倍镜下看,其实不管什么标本,都是先从低倍镜下看组织结构,再在高倍镜下看细胞形态。顿时,这位病理医生明白了东坡先生那首诗的真正含义。本故事纯属虚构,如有雷同纯属巧合。显微镜是我们病理医生的终身“伴侣”,我们既要爱“伴侣”,也要爱自己,如何在爱“伴侣”的同时保护好自己,且看正文:

Using the Microscope

显微镜使用

Upon arriving in the pathology department, you will most likely be given a microscope of your own. We will begin with the basics: how not to hurt yourself.

到病理科后,你很可能会得到一自己的显微镜。我们将从最基本的开始:如何不伤害自己。

Ergonomics

Many pathology residents have acquired new and painful musculoskeletal complaints after a few months at the microscope. Here are the general principles to avoid injury.

人体工程学

许多病理住院医师在使用显微镜几个月后,发现了新的痛苦的肌肉骨骼疾病。以下是避免伤害的一般原则。

A neutral neck: When looking through the eyepieces, your neck should be in a neutral position, meaning no active muscle tension is required to maintain the position. Your eyes should be pointed directly forward or slightly downward. Bad positions are those that involve flexing your neck (dropping your chin to your chest), jutting your chin forward, or turning your neck left or right. Tilt-head microscopes are optimal for this positioning, but three-ring binders under the microscope can also adjust the tilt. Your eyepieces should make no more than a 30° angle with the desk surface.

颈部无倾斜当通过目镜观察时,你的颈部应处于无倾向的位置,这意味着保持该位置不需要活动的肌肉张力。你的眼睛应该直接向前或稍微向下。不好的姿势包括弯曲你的脖子(把下巴放在胸前),向前突出你的下巴,或者左右转动你的脖子。倾斜显微镜是这种定位的最佳选择,但是显微镜下的三个环形粘合剂也可以调节倾斜。你的目镜与桌面的夹角不应超过30°。

●A straight back: Your mom was right about your posture, a straight back is better than a slouch, but you will need some help in the form of a chair with a supportive back. Your chair should hold you upright so that your head and neck can sit comfortably on top of your spine, without having to crane your neck forward. This can be accomplished by either adjusting your chair back to a more vertical position or adding a support pillow. Always sit directly in front of your microscope; having it off to one side to make more room on your desk will quickly cause back and neck pain.

●直背:关于你的姿势你妈妈是的,直背比低头垂肩要好,但是你需要一些帮助,比如有一张支撑的靠背椅子。你的椅子应该让你保持直立,这样你的头和脖子就可以舒适地坐在脊柱的上方,而不必向前抬起脖子。这可以通过调整您的椅子回到一个更垂直的位置或增加一个支持枕头来实现。总是坐在显微镜的正前方;把它放在一边,在桌子上腾出更多的空间,会很快导致背部和颈部疼痛。

 

 

●Supported elbows: You will be using two hands all the time, one to drive the slide and one to focus. Either job can be done with either hand, but both elbows need to be supported on the desk. Leaving your elbows floating in space while doing fine movements with your hand will lead to a nasty parascapular back spasm. Therefore, your chair should be high enough that you can place your forearms flat on the desk in front of you, with your upper arms perpendicular to the floor and flat against your torso. This may create a new problem for your neck (see the first point) if your microscope is not tall enough to meet your eyes. A good thick book or two under the microscope should fix this problem. Shorter people may also require a footstool to maintain this chair height.

●支撑肘部:你将始终使用两只手,一只手移动玻璃,一只手聚焦。任何一项工作都可以用任何一只手完成,但两个胳膊肘都需要支撑在桌子上。当你用手做精细的动作时,手肘在空中漂浮会导致严重的肩胛旁背部痉挛。因此,你的椅子应该足够高,你可以把你的前臂平放在你前面的桌子上,你的上臂垂直于地板,平放在你的躯干上。如果你的显微镜不够高,不能满足你的眼睛,这可能会给你的脖子(见第一点)带来新的问题。显微镜下一两本厚书就能解决这个问题。身材矮小的人也可能需要一个脚凳来保持椅子的高度。

● A padded surface: Your driving hand will probably rest on its elbow, while your focusing hand will lay flat on the desk. For both arms, the point of contact with the table should be padded to avoid a compression neuropathy (often the ulnar nerve). Possible solutions involve pieces of rug or bathmat, sponges, mouse pads, or commercial gel pads designed for desk users.

●垫面:你用来移动玻璃手可能会支撑肘部,而你调聚焦的手会平放在桌子上。对于双臂,应垫上与手术台接触的部位,以避免压迫神经(通常是尺神经)。可能的解决方案包括地毯或浴垫,海绵,鼠标垫,或为桌上用户设计的商业凝胶垫。

●Pay attention: When something starts to hurt, take a moment to critically analyze your posture and position. Focus on which muscle group is hurting you and what action relieves it and jury-rig a way to achieve the more comfortable position. You cannot “push through” the pain; you will only end up with a chronic repetitive motion injury that will be with you for months or years. Once the cycle of pain and muscle spasm has begun, it can be very difficult to reverse it, short of taking a few months away from the microscope.

●注意:当有东西开始伤害时,花点时间批判性地分析你的姿势和位置关注哪个肌肉群会伤害你,哪些动作会减轻你的痛苦,应急方式达到更舒适的姿势。你不能“推开”疼痛;你只会以一种慢性重复运动损伤而结束,这种损伤将伴随你数月或数年。一旦疼痛和肌肉痉挛的周期开始了,就很难逆转,除非离开显微镜几个月。


作者简介

慧海拾穗,主治医师。

从事儿童病理诊断,对淋巴造血、软组织和泌尿生殖系统肿瘤有着浓厚的兴趣。

座右铭:《为病寻理》就要爱病理!


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