Kubikwa ukuthi uMnyango Wezamathambo kanye Nezimila waseWuhan Union Hospital usuqede ukuhlinzwa kokuqala "okuprintiwe nge-3D reverse shoulder arthroplasty enokwakhiwa kabusha kwe-hemi-scapula". Ukuhlinzwa okuphumelelayo kuphawula ukuphakama okusha kobuchwepheshe bokususwa nokwakhiwa kabusha kwesimila sehlombe lesibhedlela, okuletha izindaba ezinhle ezigulini ezinamacala anzima.
U-Anti Liu, oneminyaka engu-56 kulo nyaka, wayenobuhlungu ehlombe langakwesokudla eminyakeni eminingana edlule. Buye baba bubi kakhulu ezinyangeni ezine ezedlule, ikakhulukazi ebusuku. Isibhedlela sendawo sathola "izilonda ze-tumor side cortical side" efilimini. Weza e-Orthopedics and Tumor Department of Wuhan Union Hospital ukuze athole ukwelashwa. Ngemva kokuba ithimba likaProfesa Liu Jianxiang lithole isiguli, kwenziwa ukuhlolwa kwe-CT kanye ne-MR joint yehlombe, kanti lesi simila sasihilela i-humerus proximal kanye ne-scapula, ngezindlela eziningi. Okokuqala, kwenziwa i-biopsy yendawo yesiguli, futhi ukuxilongwa kwe-pathological kwaqinisekiswa njenge-"biphasic synovial sarcoma yehlombe langakwesokudla". Njengoba lesi simila siyisimila esibi futhi isiguli okwamanje sinokugxila okukodwa emzimbeni wonke, ithimba lakha uhlelo lokwelashwa oluzimele lokususwa okuphelele kwesiguli kokuphela kwe-humerus kanye nengxenye ye-scapula, kanye nokufakwa esikhundleni kwe-3D-printed reverse shoulder joint. Inhloso ukufeza ukususwa kwesimila kanye nokwakhiwa kabusha kwe-prosthesis, ngaleyo ndlela kubuyiselwe isakhiwo kanye nokusebenza kwejoyinti lehlombe lesiguli okuvamile.
Ngemva kokuxhumana ngesimo sesiguli, uhlelo lokwelashwa, kanye nemiphumela yokwelapha elindelekile nesiguli nomndeni waso, nokuthola imvume yaso, ithimba laqala ukulungiselela ukuhlinzwa kwesiguli ngokujulile. Ukuze kuqinisekiswe ukususwa okuphelele kwesimila, ingxenye ye-scapula idinga ukususwa kulokhu kuhlinzwa, futhi ukwakhiwa kabusha kwesihlanganisi sehlombe kuyiphuzu elinzima. Ngemva kokubuyekezwa ngokucophelela kwamafilimu, ukuhlolwa ngokomzimba, kanye nengxoxo, uSolwazi Liu Jianxiang, uDkt. Zhao Lei, kanye noDkt. Zhong Binlong bakha uhlelo lokuhlinzwa olunemininingwane futhi baxoxa ngokuklama nokucubungula isimila nonjiniyela izikhathi eziningi. Balingisa ukufakwa kwe-tumor osteotomy kanye ne-prosthesis kumodeli ephrintiwe nge-3D, bakha "ukwenziwa ngokwezifiso kwangasese" kwesiguli - isimila esihlangene sehlombe esingemuva esifanelana namathambo abo e-autologous ngesilinganiso esingu-1:1.
A. Linganisa ububanzi be-osteotomy. B. Dizayina i-prosthesis ye-3D. C. Phrinta i-prosthesis ye-3D. D. Faka i-prosthesis kusengaphambili.
Ijoyinti lehlombe elingemuva lihlukile kujoyinti lehlombe elenziwe ngendlela yendabuko, lapho ubuso bejoyinti eliyindilinga bubekwe ohlangothini lwe-scapular lwe-glenoid kanye nendebe ebekwe ku-humerus eseduze enqunyelwe ingxenye engxenyeni yejoyinti lehlombe eliphelele elinqunyelwe ingxenye. Lokhu kuhlinzwa kunezinzuzo ezilandelayo: 1. Kungafanelana kakhulu neziphambeko ezinkulu zamathambo ezibangelwa ukususwa kwesimila; 2. Izimbobo zokwakha kabusha i-ligament ezenziwe ngaphambilini zingalungisa izicubu ezithambile ezizungezile futhi zigweme ukungazinzi kwamalunga okubangelwa ukususwa kwe-rotator cuff; 3. Isakhiwo se-bio-mimetic trabecular ebusweni be-prosthesis singakhuthaza ukukhula kwamathambo nezicubu ezithambile ezizungezile; 4. Ijoyinti lehlombe elingemuva elenziwe ngendlela yakho linganciphisa ngempumelelo izinga lokususwa kwe-prosthesis ngemva kokuhlinzwa. Ngokungafani nokufakwa esikhundleni kwehlombe elingemuva okuvamile, lokhu kuhlinzwa kudinga nokususwa kwekhanda lonke le-humeral kanye nengxenye yendebe ye-scapular, kanye nokwakhiwa kabusha kwekhanda le-humeral nendebe ye-scapular njengebhulokhi lonke, okudinga ukwakheka okunembile kanye nobuchwepheshe obuhle kakhulu bokuhlinzwa.
Ngemva kokuhlela ngokucophelela nokulungiselela ngesikhathi sokuhlinzwa, ukuhlinzwa kwenziwe ngempumelelo esigulini muva nje, ngaphansi kokuqondisa kukaSolwazi Liu Jianxiang. Ithimba lisebenzisane eduze futhi lenza imisebenzi eqondile ukuze kuqedwe ukususwa okuphelele kwesimila, i-osteotomy enembile ye-humerus ne-scapula, ukufakwa nokuhlanganiswa kwe-prosthesis yokwenziwa, okwathatha amahora ama-2 ukuqedwa.
D: Sika ngokunembile yonke i-humerus kanye ne-scapula ngepuleti lokuqondisa lokusika amathambo ukuze ususe isimila (H: I-fluoroscopy yokususwa kwesimila ngesikhathi sokuhlinzwa)
Ngemva kokuhlinzwa, isimo sesiguli sasisihle, futhi bakwazi ukunyakaza ngosizo lwe-brace esithweni esithintekile ngosuku lwesibili futhi benze ukunyakaza kwamalunga ehlombe okungenamsebenzi. Ama-X-ray alandelayo abonise indawo enhle yokufakelwa kwamalunga ehlombe kanye nokululama okuhle kokusebenza.
Ukuhlinzwa kwamanje kuyicala lokuqala eWuhan Union Hospital Department of Orthopedics elisebenzisa umhlahlandlela wokusika ophrintiwe nge-3D kanye ne-prostheses ezenzelwe wena ukuze kufakwe i-reverse shoulder joint kanye ne-hemi-scapula. Ukusetshenziswa ngempumelelo kwalolu buchwepheshe kuzoletha ithemba lokusindisa izitho ezigulini eziningi ezinezimila zamahlombe, futhi kuzuzise inani elikhulu leziguli.
Isikhathi sokuthunyelwe: Ephreli-28-2023
