Posachedwapa, Liu Hucheng, mkulu wa Dipatimenti ya Bone ndi Soft Tissue Oncology pa First Affiliated Hospital ya Nanchang University, anamaliza "pelvic chotupa resection + sacral osteotomy + pelvic replacement + hip m'malo + lumbar pedicle screw internal fixation" ndi LDK Customized pelvic prosthesis. , ndipo opaleshoniyo 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 + chiuno m'malo + 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 adadandaula kuti pa 2022-10, panalibe chifukwa chodziwikiratu cha kupweteka kwa msana ndi kusamva bwino, ndi ululu ndi kutupa, limodzi ndi ululu kumanzere kumanzere, komwe kuli m'chiuno chakumanzere, kumanzere kumanzere, kumbuyo kumbuyo. wa ntchafu, kumbuyo mbali ya ng'ombe ku phazi lamanzere, dzanzi pansi pa phazi lamanzere, ululu unawonjezeka pambuyo pa kuyima ndi kuyenda kwa nthawi yaitali, ndipo ukhoza kumasulidwa pamene akupuma, pamene palibe chidwi 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 kukaunika:
Chotupa cham'chiuno chakumanzere chinatumizidwa kuti chikawunikidwe: fupa losaoneka bwino, kukula kwa 19.5X17X9 cm, ndi minofu yolumikizidwa, kukula kwa 16.5X16X3.5 cm, kudulidwa kwamitundu yambiri, masentimita 1.5 kuchokera m'mphepete mwa cautery, misa inawoneka mu minofu ya minofu. , kukula 8X6.5X4.5 masentimita, imvi yofiira, yolimba, komanso yosalongosoka bwino pakati pa malo olunjika ndi fupa.
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 kwa mitsempha ya sciatic) kukhudzidwa kwa zilonda zooneka: ma lymph nodes ena a 2 amawoneka, palibe metastasis yomwe inawoneka (0/2) Immunohistochemistry imasonyeza: CK (-); Vimentin (3+); Ki-67 (75% +); ;IMP3(+);MDM2(+);P16(+);S-100(mwazikana +);H3.3G34W(-);Brachyury(-)；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