Posachedwapa, Liu Hucheng, mkulu wa Dipatimenti ya Bone ndi Soft Tissue Oncology pa First Affiliated Hospital of Nanchang University, anamaliza "pelvic chotupa resection + sacral osteotomy + pelvic replacement + hip m'malo + lumbar pedicle screw internal fixation" ndi LDK makonda a m'chiuno prosthesis, ndipo ntchito inayenda bwino.
Wodwalayo adatumizidwa ku chipatala chakunja chifukwa cha ululu wammbuyo komanso kusamva bwino. Atamaliza mayeso okhudzana ndi chiuno, wodwalayo adanenedwa kuti ali ndi zilonda zowopsa za osteo-malignant, koma sanachite chidwi ndi izi, ndiyeno zizindikiro zake zowawa zidakulirakulira ndipo kuyenda kwake kunali kochepa. Kenako wodwalayo adabwera ku dipatimenti ya Bone and Soft Tissue Oncology of the First Affiliated Hospital of Nanchang University kuti akalandire chithandizo.
Atagonekedwa m'chipatala ndikumaliza kufufuza kwa mafupa a m'chiuno, wodwalayo adapezeka ndi osteosarcoma. Pambuyo pa ndondomeko yokwanira ya opaleshoni inapangidwa pamodzi ndi madipatimenti angapo ndipo kukonzekera kusanachitike kunamalizidwa, Mtsogoleri Liu Hu Cheng gulu anachita "pelvic chotupa resection + sacral osteotomy + m'malo m'chiuno + m'malo m'chiuno + lumbar arch wononga mkati fixation" kwa wodwalayo.
Kufotokozera:
Wodwala, wamkazi, wazaka 52
Dandaulo:
Miyezi yopitilira 3 pambuyo pa chemotherapy ya pelvic bone osteosarcoma
Mbiri yakale yachipatala:
Wodwalayo anadandaula kuti pa 2022-10, panalibe chifukwa chodziwikiratu cha kupweteka kwapang'onopang'ono komanso kusokonezeka, ndi ululu ndi kutupa, limodzi ndi ululu kumanzere kumanzere, kumanzere kwa ntchafu, kumanzere, kumbuyo kwa ntchafu, kumbuyo kwa ng'ombe ku phazi lamanzere, kumanzere kumanzere, kumanzere kumanzere, kumanzere kumanzere, kumanzere ndi kumanzere kumanzere. khalani omasuka pamene mukupumula, panthawi yomwe palibe chidwi chomwe chinaperekedwa, ndiyeno zizindikiro zowawa zinayamba kuwonjezeka ndipo sanathe kuyenda.
MRI inati: 1) chizindikiro chachilendo cha fupa lamanzere la iliac, poganizira kuti pali zilonda zoopsa; 2) kachulukidwe kakang'ono kamadzimadzi m'chiuno chakumanzere. Palibe chithandizo chapadera chimene chinaperekedwa, ndipo tsopano wodwalayo anagonekedwa m’chipatala kuti akalandire chithandizo china.
Kuzindikira kwachipatala:
"Postchemotherapy myelosuppression" kuvomereza
Njira yomwe akufunira ndi "pelvic chotupa resection + sacral osteotomy + pelvic replacement + chiuno m'malo + kukonza mkati ndi lumbar pedicle screw"
Zitsanzo zotumizidwa kuti zikawunikidwe:
Chotupa cham'chiuno chakumanzere chinatumizidwa kuti chikawunikidwe: minofu ya mafupa osaoneka bwino, kukula kwa 19.5X17X9 masentimita, yokhala ndi minofu ya minofu, kukula kwa 16.5X16X3.5 cm, kudulidwa kwamitundu yambiri, masentimita 1.5 kuchokera pamphepete mwa cautery, unyinji unkawoneka mu minofu, kukula kwa 8X6.5X4.5 cm, fupa losauka ndi fupa losauka, fupa losauka ndi fupa losauka, fupa losauka ndi fupa la grayish ndi grayish. minofu.
Chotupa cha sciatic kumanzere: minofu yotuwa yopanda mawonekedwe, kukula 9.5X3X3m, imvi yotuwa yofiira yolimba pamtunda wodulidwa.
Tizilombo tosaoneka, chotupa anasonyeza olimba lamellar kugawa, kuukira zotumphukira fibrofat, yopingasa minofu ndi minyewa minofu, ndi maselo osakhazikika zooneka ngati nucleoli zoonekeratu, zosavuta kuona nyukiliya schizophrenia, heterotypes zoonekeratu ndi zambiri necrosis.
Kuzindikira kwa Pathologic:
(Kumanzere kwa pelvis) Kuphatikizana ndi zachipatala, kujambula ndi mbiri yakale, zinali zogwirizana ndi kuyankha pambuyo pa chemotherapy kwa osteosarcoma yapamwamba kwambiri (mtundu wamba).
Huvos grading: giredi II (chemotherapy yothandiza pang'ono,> 50% chotupa minofu necrosis, kupulumuka chotupa minofu).
Mphepete mwa minyewa ya minofu: palibe chotupa chomwe chinawonedwa.
(kumanzere sciatic minyewa) chotupa chowoneka kukhudzidwa: 2 ma lymph nodes ena awona, palibe metastasis yomwe idawonedwa (0/2) Immunohistochemistry ikuwonetsa: CK (-) ; Vimentin (3+) ;Ki-67 (75% +) ;SATB2 (+); IMP3 (+); MDM2 (+); P16 (+) ; +);H3.3G34W(-);Brachyuri(-);Desmin(-);CD68(-).
Kukonzekera Opaleshoni:
Kuchotsa chotupa cha m'chiuno + sacral osteotomy + m'malo mwa pelvic + m'malo mwa m'chiuno + lumbar pedicle screw internal fixation.
Preoperative
Postoperative
Chiyambi cha Opaleshoni
Prof. Hucheng Liu
Chipatala Choyamba Chogwirizana cha Nanchang University Orthopedic Hospital
Chief, Department of Bone and Soft Tissue Oncology
Dokotala wamkulu, Pulofesa Wothandizira, Woyang'anira Master
Mtsogoleri wa Bone and Soft Tissue Tumor Group, Orthopedic Branch, Jiangxi Medical Association
Wachiwiri kwa Wapampando wa Bone and Soft Tissue Tumor Committee ya Jiangxi Physicians Association Orthopedic Branch.
Nthawi yotumiza: Apr-26-2023