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德国儿科心脏病学的历史。

History of German pediatric cardiology.

作者信息

Heintzen P

出版信息

Z Kardiol. 2002;91 Suppl 4:74-80. doi: 10.1007/s00392-002-1412-z.

Abstract

Due to the isolation of German medicine in World War II accompanied by the destruction of many hospitals, German pediatricians did not show any serious interest in the treatment of children with congenital heart diseases, nor did they take notice of the progress achieved by Helen Taussig, Alfred Blalock and other cardiologists and surgeons in the western world. This problem was even worse in East Germany. Only a few German internists and forward-looking surgeons were able and ready to take care of this group of principally operable children in places like Bonn/Düsseldorf, Marburg/Munich, Berlin, and Hamburg. However, in the early 1950s some directors of pediatrics at university hospitals--largely motivated by the cardiac surgeons--allowed or even encouraged younger colleagues to concentrate on pediatric cardiology and to begin application of heart catheterization and angiocardiography. In 1960 a group of colleagues interested in pediatric cardiology met for the first time in Frankfurt and became the nucleus of the future "working group" (1969) and finally the "German Society of Pediatric Cardiology" (1974). By 1972 pediatric cardiology had been approved as an independent (sub)specialty. Colleagues and friends from surrounding countries (Austria, Great Britain, Sweden, Switzerland, and the Netherlands) and also from the US and some eastern countries were either members or regular guests during or between the meetings. Pediatric cardiology is now represented in Germany by specialized practitioners, trainees and assistants who work in both community and university hospitals, and in specialized departments. Due to the foresightedness of the Chief of Pediatrics, Prof. G. Joppich, the first Chair of Pediatric Cardiology was founded in Göttingen in 1960 under the direction of A. Beuren. Another model of interdisciplinary cooperation between pediatric cardiologists, bioengineers, mathematicians and computer scientists was established in Kiel in 1966. In other places pediatric and adult cardiologists were brought together in "Heart Centers" with cardiovascular surgeons. The first of these Heart Centers was founded in 1974 in Munich under the directorship of K. Bühlmeyer and comparable centers were later established in Bad Oeynhausen (1985) and Berlin (1986). Following reunification in 1990, pediatric cardiologists from the east and west came together. Thus, within the last three to four decades German pediatric cardiology gradually caught up with international standards and in some fields of cardiovascular research even assumed a leading role. The care of the growing numbers of surviving patients with congenital heart disease has become a new challenge that has to be met by experienced cardiologists. To maintain the level of competence, future activities should however, not only concentrate on the optimal care of patients with congenital heart disease but also be responsible for cardiovascular research.

摘要

由于二战期间德国医学处于孤立状态,许多医院遭到破坏,德国儿科医生对先天性心脏病患儿的治疗并未表现出任何浓厚兴趣,也未关注海伦·陶西格、阿尔弗雷德·布莱洛克等心脏病专家和外科医生在西方世界所取得的进展。在东德,这个问题更为严重。只有少数德国内科医生和有远见的外科医生能够并且愿意在波恩/杜塞尔多夫、马尔堡/慕尼黑、柏林和汉堡等地照顾这群原则上可手术治疗的患儿。然而,在20世纪50年代初,一些大学医院的儿科主任——很大程度上受心脏外科医生的推动——允许甚至鼓励年轻同事专注于小儿心脏病学,并开始应用心导管检查和心血管造影术。1960年,一群对小儿心脏病学感兴趣的同事首次在法兰克福相聚,成为未来“工作组”(1969年)的核心,最终成为“德国小儿心脏病学会”(1974年)的核心。到1972年,小儿心脏病学已被批准为一个独立的(亚)专科。来自周边国家(奥地利、英国、瑞典、瑞士和荷兰)以及美国和一些东欧国家的同事和朋友在会议期间或会议间隙要么是成员,要么是常客。如今,在德国,小儿心脏病学由在社区医院和大学医院以及专科部门工作的专科医生、实习生和助手来代表。由于儿科主任G. 约皮希教授的远见卓识,1960年在A. 博伊伦的指导下,哥廷根设立了首个小儿心脏病学教授职位。1966年,在基尔建立了小儿心脏病专家、生物工程师、数学家和计算机科学家之间跨学科合作的另一个模式。在其他地方,小儿心脏病专家和成人心脏病专家与心血管外科医生一起被集中在“心脏中心”。首个这样的心脏中心于1974年在慕尼黑由K. 比尔迈尔主持成立,类似的中心后来在巴特奥伊瑙森(1985年)和柏林(1986年)建立。1990年德国统一后,东、西德的小儿心脏病专家汇聚在一起。因此,在过去的三到四十年里,德国小儿心脏病学逐渐赶上国际标准,在心血管研究的一些领域甚至发挥了主导作用。照顾越来越多存活的先天性心脏病患者已成为经验丰富的心脏病专家必须应对的新挑战。然而,为了保持专业水平,未来的活动不仅应专注于先天性心脏病患者的最佳护理,还应对心血管研究负责。

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