پروژه لیزر و لیزر درمانی (کاربرد های آن در پزشکی)

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دانلود پروژه لیزر و لیزر درمانی (کاربرد های آن در پزشکی)

نوع فایل: word
قابل ویرایش 224 صفحه

مقدمه:
ليزر.... از اعجاز آميزترين موهبتهاي طبيعت است كه براي مصارف گوناگون سودمند است. و يكي از پديده هاي شگرف قرن بيستم كشف و توسعه ليزر (laser) است. قرن بيستم را شايد بتوان به جاي قرن اتم و يا قرن ماشين, «قرن ليزر» هم ناميد. اين اختراع شگرف و پردامنه فيزيكي روز به روز توسعه بيشتري مي يابد و كاربردهاي آن در زمينه هاي مختلف بسيار متعدد است. در حوزه پزشكي نيز در حال حاضر ليزرها در درمان انواع مختلفي از بيماريها شركت داده مي شوند. اگرچه ليزرهاي باليني جديد و كاربردهاي آنها احتمالاً در حال گذران دوران نوباوگي پزشكي ليزري هستند ولي در آينده نه چندان دور ليزرهاي ديگري پديد خواهند آمد كه جايگاه خود را در بيمارستانها و مراكز پزشكي خواهند يافت بنابراين تحقيق علمي آينده به اندازه كاربردهاي باليني حاصل از آن, زيربنايي خواهند بود.
به علت تنوع سيستم هاي ليزر موجود و تعداد پارامترهاي فيزيكي آنها و همينطور علاقه چندين گروه تحقيقاتي در واقع انواع مختلف ليزر بصورت ابزار بي رقيبي در پزشكي مدرن درآمده اند و اگرچه كاربردهاي باليني در ابتدا محدود به چشم پزشكي بوده اند، ولي امروزه قابل ملاحظه ترين و جاافتاده ترين جراحي ليزري در خصوص انعقاد خونریزی عروق با استفاده از ليزر يون آرگون Ar+ است. لذا تقريباً تمام شاخه هاي جراحي پزشكي معطوف به اين قضيه شده اند. البته نبايد اين گفته را به عنوان انتقاد برشمرد ولي اشكالات زيادي در برخي از موارد ايجاد شده است،‌ بخصوص در زمينه تحريك زيستي biostimulation. لذا به نظر اين بنده حقير لازمست براي كسب پيروزيهاي جديد، محققان عزم خود را در ساير زمينه ها پژوهش پزشكي ليزر و تكنيك هاي فني و حرفه اي مربوط به آنها نيز مجدانه جذب كنند و در پي وسعت دادن ابعادي به اين امر مهم باشند. البته در كل، بسياري از تكنيكهاي ليزري واقعاً مفيد، كه از لحاظ باليني محقق شده اند، به كمك انواع دانشمندان قرن حاضر توسعه يافته اند. اين روشهاي معالجه توسط محققان ديگر تأييد شده و در مجلات علمي معتبر به نحوه مناسب به نوشتار درآمده است. حتي اخيراً در رابطه با كاربردهاي اوليه ليزر كه اساساً بر نتايج درماني متمركز شده بودند, چندين روش جالب تشخيصي نيز اضافه شده است. براي نمونه مي توان تشخيص تومورها توسط رنگهاي فلورسانس و يا تشخيص پوسيدگي دندان بوسيله تحليل طيف سنجي بارقه پلاسمايي حاصل از ليزر را نام برد.
همانطور كه ميدانيم در اواخر دهه 1960 ليزر در زمينه هاي پزشكي بکار رفت. امروزه تعداد بسياري از روش هاي كاربرد ليزر در سراسر جهان بكارگرفته مي شود. بيشتر اين روشها متعلق به خانواده جراحي با كمترين تهاجم (MIS) minimally invasive surgery مي باشند. اين اصطلاح جديد که در دهه حاضر پديد آمده است به تكنيك هاي جراحي اي اطلاق مي شود كه در آنها تماس با بدن و خونريزي صورت نمي گيرد. لذا اين دو مشخصه بطور عمده باعث شده اند كه ليزر به عنوان يك تيغ جراحي و وسيله درمان جهاني بكار گرفته شود. در واقع بسياري از بيماران و همچنين جراحان بر اين باورند كه ليزر وسيله اي اعجاب انگيز است. البته اين شيوه تفكر منجر به نگرشهاي گمراه كننده و توقع هاي نابجا نيز شده است. در حقيقت قضاوت دقيق در مورد پيشرفتهاي جديد هميشه لازم است. مثلاً وقتي كه يك روش درمان توسعه ليزر معرفي مي شود, تا هنگام تأييد شدن آن توسط مطالعات مستقل ديگر، نبايد مورد قبول واقع شود. اثرات ناشي از ليزر همانطور كه مي دانيم بسيار متعدداند. بيشتر آنها را مي توان بطور علمي توضيح داد. البته برخي اثرات كه براي يك درمان ويژه مفيد هستند, براي موارد ديگر ممكن است خطرناك باشند بعنوان مثال گرم كردن يك بافت سرطاني توسط پرتوي ليزر مي تواند منجر به اثر مطلوب نكروز (تخريب) تومور شود. و بالعكس بكار بردن پرتوي ليزري براي قطع خونريزي شبكيه چشم با پارامترهاي فوق، مي تواند منجر به سوختن خود شبكيه و نابینایي غيرقابل برگشت شود. به هرحال با توجه به تسهيلاتي كه پديده ليزر در امر تشخيص و درمان در علم پزشكي فراهم نموده, آينده روشن تري را مي توان براي نسل بشر پيش بيني كرد.

فهرست مطالب:
پیشگفتار
مقدمه
تاریخچه لیزر
تعریف لیزر
فیزیک لیزر
مبانی نظری لیزر
انواع لیزر
معرفی لیزرهای توان پایین
اثرات لیزرهای کم قدرت
مکانیسم برهمکنش بافت – لیزر
درمان فتودینامیک
مقایسه لیزرهای توان بالا با لیزرهای توان پایین
روش های کاربرد لیزر توان پایین
رویکرد بالینی لیزرهای توان پایین
کاربرد در فیزیوتراپی
کاربرد در دندانپزشکی
کاربرد در پزشکی (افتالموژی – اورولوژی – دستگاه گوارش – دستگاه تنفس)
کاربرد در پوست و اعصاب
عوارض احتمالی درمان با لیزرهای کم توان
سایر روش های درمان بالینی
خطرات جانبی لیزرها و نکات ایمنی و حفاظتی
نتيجه گيري
مراجع

منابع و مأخذ:
1) مجموعه مقالات کنفرانس ملی کاربردهای لیزر در پزشکی و مهندسی پزشکی دانشگاه صنعتی امیرکبیر دانشکده مهندسی پزشکی.
Proceedings of National conference on Applications of Lasers in Medicine and Biomedical Engineering Amir Kabir University of Technology Faculty of Biomedical Engineering
2) فتودینامیک درمانی بر هم کنش بافت ماده شیمیایی ، زاما، 1378، سال اول، شماره دوم، 37-32.
3) مبانی و کاربردهای تأثیرات متقابل لیزر- بافت - تألیف مارکوف اچ. نیمز سال 1964.
Laser – Tissue interactions Fundamentals and applications
Markof H. Niemz / springer- verlag, 1996
4) لیزر در پزشکی و فیزیوتراپی – تألیف عطاء الله هادی (انجمن فیزیوتراپی ایران)، با همکاری ویرایش علمی دکتر اکبر حریری (سازمان انرژی اتمی ایران)
Laser in Medicine and physiothraphy
5) کتاب راهنمای ایمنی لیزر (چاپ نهم 1993) – این کتاب توسط مؤسسه لیزر آمریکا، اورلاندو ، فلوریدا، ایالت متحده تألیف و چاپ گردید.
D.H.sliney
6) اصول لیزر – تألیف اوراسیو سوولتو – ترجمه دکتر اکبر حریری- حسین گل بنی.
Principles of lasers
orazio svelto/plenum press 1982

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