Meshalkin Novosibirsk State Research Institute of Circulation Pathology, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, Russia.
Institute of Archaeology and Ethnography, Russian Academy of Sciences Siberian Branch, Novosibirsk, Russia.
World Neurosurg. 2014 Nov;82(5):e649-55. doi: 10.1016/j.wneu.2014.06.045. Epub 2014 Jul 5.
To report the analysis of 3 cases of ancient trepanation discovered in the craniological collection (153 skulls) of the Pazyryk nomadic culture (500-300 bc) from the Gorny Altai, Russia, and to evaluate the technique, instrumentation, and materials used for cranial surgery as well as the motivation for the trepanations in Scythian times.
A multidisciplinary approach was chosen to study the trepanned skulls. Visual inspection and examination under magnification, multislice computed tomography, high-field magnetic resonance imaging, and coupled plasma mass spectrometry and synchrotron radiation-induced x-ray fluorescence analysis of the bone samples from the site of trephination were used.
In the Pazyryk culture, trepanation was very likely used to perform the intracranial procedures that were not yet indicated by Hippocrates. No signs of bone infection were detected. Higher copper abundance found at the site of trepanation showed that a bronze knife was the most likely tool used by Scythian surgeons.
Our data suggest that the Scythian population of the Altai Mountains had sufficient medical knowledge to perform sophisticated and successful manipulations on the human skulls. Scraping technique with bronze tools was quite effective for prevention of wound infection and resulted in a high survival rate after surgery. In the era of methicillin-resistant Staphylococcus aureus, it may be useful to consider some ancient surgical technologies.
报告对俄罗斯戈尔诺-阿尔泰地区（公元前 500 年至 300 年）佩拉约夫卡游牧文化颅骨学收藏（153 个头骨）中发现的 3 例古代环锯术案例的分析，评估斯基泰时期进行颅骨手术所使用的技术、仪器和材料，以及环锯术的动机。
选择多学科方法研究环锯术颅骨。采用肉眼观察和放大检查、多层计算机断层扫描、高磁场磁共振成像以及对钻孔部位的骨样本进行耦合等离子体质谱和同步辐射诱导 X 射线荧光分析。
在佩拉约夫卡文化中，环锯术很可能用于实施希波克拉底尚未指出的颅内手术。未发现骨感染的迹象。在钻孔部位发现的铜含量较高表明，青铜刀很可能是斯基泰外科医生使用的工具。
我们的数据表明，阿尔泰山脉的斯基泰人群具有足够的医学知识，可以对人类颅骨进行复杂而成功的操作。青铜工具的刮除技术对于预防伤口感染非常有效，并且手术后的存活率很高。在耐甲氧西林金黄色葡萄球菌时代，考虑一些古代手术技术可能会有所帮助。
