Kubikwa ukuthi uMnyango Wezamathambo kanye Nezimila weSibhedlela i-Wuhan Union usuqede ukuhlinzwa kokuqala “okuphrintiwe nge-3D okuphrintiwe komuntu siqu kwe-reverse ehlombe nge-hemi-scapula reconstruction”.Ukuhlinzwa okuyimpumelelo kubonisa ukuphakama okusha ekukhishweni kwesimila esihlangene ehlombe lesibhedlela kanye nobuchwepheshe bokwakha kabusha, okuletha izindaba ezinhle ezigulini ezinezimo ezinzima.
U-Anti uLiu, oneminyaka engama-56 ubudala kulo nyaka, wayenezinhlungu zehlombe langakwesokudla eminyakeni embalwa edlule.Kube kubi kakhulu ezinyangeni ezi-4 ezedlule, ikakhulukazi ebusuku.Isibhedlela sendawo sithole "izilonda ze-humeral cortical side tumor" kwifilimu.Weza eMnyangweni Wamathambo kanye Nezimila esibhedlela i-Wuhan Union ezokwelashwa.Ngemva kokuba ithimba likaProfesa Liu Jianxiang lithole isiguli, kwenziwa ukuhlolwa kwe-CT kanye ne-MR ngokuhlanganyela ehlombe, futhi isimila sasihilela i-proximal humerus ne-scapula, enobubanzi obubanzi.Okokuqala, i-biopsy ye-puncture yendawo yenzelwe isiguli, futhi ukuxilongwa kwe-pathological kwaqinisekiswa ngokuthi "i-biphasic synovial sarcoma yehlombe elingakwesokudla".Uma kucatshangelwa ukuthi isimila siyithumba eliyingozi futhi isiguli njengamanje sinokugxila okukodwa kuwo wonke umzimba, ithimba lenze uhlelo lokwelashwa komuntu ngamunye ukuze kususwe isiguli-ngokuphelele kokuphela okuseduze kwe-humerus nengxenye ye-scapula, kanye ne-3D- ephrintiwe yokwenziwa reverse ehlombe joint replacement.Inhloso ukufeza ukususwa kwesimila kanye nokwakhiwa kabusha kwe-prosthesis, ngaleyo ndlela kubuyiselwe ukwakheka nokusebenza okujwayelekile kwehlombe kwesiguli.
Ngemva kokukhuluma ngesimo sesiguli, uhlelo lokwelapha, nemiphumela yokwelapha elindelekile nesiguli nomndeni waso, nokuthola imvume yabo, ithimba laqala ukulungiselela ukuhlinzwa kwesiguli ngokujulile.Ukuze kuqinisekiswe ukukhishwa okuphelele kwe-tumor, isigamu se-scapula sidinga ukususwa kulo msebenzi, futhi ukwakhiwa kabusha kwehlombe lehlombe kuyiphuzu elinzima.Ngemva kokubuyekezwa ngokucophelela kwamafilimu, ukuhlolwa ngokomzimba, nengxoxo, uProfesa Liu Jianxiang, uDkt. Zhao Lei, noDkt. Zhong Binlong benza uhlelo lokuhlinza oluningiliziwe futhi baxoxa ngokuklanywa nokucutshungulwa kwesitho sokufakelwa nonjiniyela izikhathi eziningi.Balingise i-tumor osteotomy kanye nokufakwa kwe-prosthesis kumodeli ephrintiwe ye-3D, bakha “ukwenza ngokwezifiso okuyimfihlo” kwesiguli - i-prosthesis yokwenziwa ehlangene yehlombe ehlanekezelanayo efana namathambo abo e-autologous ngesilinganiso esingu-1:1.
A.Linganisa ububanzi be-osteotomy.B. Dizayina i-3D prosthesis.C. 3D phrinta i-prosthesis.D. Faka ngaphambilini i-prosthesis.
Ijoyinti yehlombe ehlehlayo ihlukile ekuhlanganyeleni kwehlombe okwenziwe ngokwesiko kwendabuko, indawo ehlangene eyindilinga ebekwe ohlangothini lwe-scapular lwe-glenoid kanye nenkomishi ebekwe ku-humerus ekhawulelwe uhhafu we-prosthesis ehlangene yehlombe ekhawulelwe kancane.Lokhu kuhlinzwa kunalezi zinzuzo ezilandelayo: 1. Kungafanelana kakhulu nokukhubazeka okukhulu kwamathambo okubangelwa ukukhishwa kwesimila;2. Izimbobo zokwakhiwa kabusha kwe-ligament ezenziwe ngaphambilini zingalungisa izicubu ezithambile ezizungezile futhi zigweme ukungazinzi okuhlangene okubangelwa ukukhishwa kwe-rotator cuff;3. Isakhiwo se-bio-mimetic trabecular ebusweni be-prosthesis singakhuthaza ukungena kwethambo elizungezile kanye nezicubu ezithambile;4. Ijoyinti yehlombe elihlanekezelwe lomuntu siqu linganciphisa ngempumelelo izinga lokususwa kwe-postoperative ye-prosthesis.Ngokungafani nokushintshwa kwehlombe okuvamile, lokhu kuhlinzwa kudinga nokususwa kwekhanda lonke le-humeral kanye nengxenye yendebe ye-scapular, nokwakhiwa kabusha kwekhanda le-humeral kanye nenkomishi ye-scapular iyonke ibhulokhi, okudinga ukuklama okunembayo kanye nendlela yokuhlinza enhle kakhulu.
Ngemva kokuhlela nokulungiselela ngokucophelela phakathi nenkathi yokuhlinzwa, ukuhlinzwa kwenziwa ngempumelelo esigulini muva nje, ngaphansi kokuqondisa kukaProfesa Liu Jianxiang.Ithimba lasebenza eduze ndawonye futhi lenza imisebenzi eqondile ukuze kuqedelwe ukususwa okuphelele kwesimila, i-osteotomy enembile ye-humerus ne-scapula, ukufakwa kanye nokuhlanganiswa kwe-prosthesis yokwenziwa, okuthathe amahora angu-2 ukuqeda.
D: Sika kahle yonke i-humerus ne-scapula ngepuleti lomhlahlandlela wokusika amathambo ukuze ususe isimila (H: I-intraoperative fluoroscopy yokususwa kwesimila)
Ngemva kokuhlinzwa, isimo sesiguli sasisihle, futhi bakwazi ukunyakaza ngosizo lwebhulashi esithweni esithintekile ngosuku lwesibili futhi benza ukunyakaza kwamalunga ehlombe angenzi lutho.Ama-X-ray okulandelela abonise ukuma okuhle kwe-prosthesis ehlangene yehlombe kanye nokululama okuhle kokusebenza.
Ukuhlinzwa kwamanje kuyicala lokuqala eMnyangweni Wezifo Zamathambo e-Wuhan Union Hospital esebenzisa umhlahlandlela wokusika ophrintiwe we-3D kanye nezitho zokufakelwa ezenziwe ngokwezifiso zokuhlanganisa ihlombe elingemuva kanye nokushintshwa kwe-hemi-scapula.Ukuqaliswa ngempumelelo kwalobu buchwepheshe kuzoletha ithemba elisindisa izitho ezigulini eziningi ezinezimila zamahlombe, futhi kuzuze inani elikhulu leziguli.
Isikhathi sokuthumela: Apr-28-2023
