Posachedwapa, Dr Zhang Guofeng, Wachiwiri kwa Sing'anga wamkulu wa dipatimenti ya Bone Oncology, Yantai Affiliated Hospital of Binzhou Medical College, ndi gulu lake bwinobwino anagwiritsa ntchito LDK mwambo chotupa prosthesis ndi anachita zovuta kwambiri "zopangidwa mwachizolowezi chotupa chotupa prosthesis m'malo" opaleshoni pa wodwala matenda zovuta, amene osati chizindikiro yojambula chitukuko cha dipatimenti ya Bone Oncology, Yantai Affiliated Hospital Binzhou Medical College, pa matenda a zilonda chotupa fupa komanso ankaimira mkulu mlingo luso lake opaleshoni anali afika pa m'banja patsogolo mlingo. .
Kufotokozera za chikhalidwe
Wodwala, wamkazi, zaka 70
Chaka chapitacho wodwalayo anayamba zizindikiro zowawa m’ntchafu yake yakumanja, zomwe zinakula pang’onopang’ono.Wodwalayo ankaganiza kuti ali ndi necrosis ya mutu wa chikazi, koma ululu umakhalabe wolimba atamwa mankhwala opweteka.Posachedwapa, adapita ku Yantai Affiliated Hospital ku Binzhou Medical College popeza ululuwo unakula kwambiri moti sankagonanso usiku kapena kuyenda.
MRI ya olowa ake akuwonetsa chizindikiro chachilendo chakumbuyo chakumanja kwa chikazi chakumanja, ndipo chotupacho chidaganiziridwa.Wodwalayo adaloledwa ku Dipatimenti ya Bone Oncology kuti apitirize chithandizo.
Pambuyo pofufuza mwatsatanetsatane, gulu la wachiwiri kwa dokotala Zhang Guofeng adatsimikizira kuti ali ndi chotupa cha metastatic mu femur yolondola, ndipo chotupa chachikulu chinkawoneka ngati khansa ya m'mapapo yotumphukira.Pambuyo polankhulana mokwanira ndi wodwalayo ndi banja lake, opaleshoni inasankhidwa.
Chovuta Landirani!Medical-industrial Integration kwa opaleshoni yovuta m'malo
Vuto lovuta kwambiri kwa madokotala linali loti wodwalayo anali ndi zaka 70 zakubadwa ndipo chapamwamba chakumanja ndi chapakati cha femur chawonongeka kwambiri ndi kukokoloka kwa chotupa, ngakhale chikazi cha distal chomwe sichinawonongeke sichinasiyidwe kwambiri, kotero njira zomanganso zokhazikika pambuyo pa chotupa. resection sizinagwirenso ntchito.Pambuyo mobwerezabwereza kayeseleledwe ndi kukambirana, Dr. Zhang Guofeng gulu anaganiza kuchita chotupa resection chapamwamba ndi pakati femur + makonda chotupa prosthesis m'malo.
MRI Preoperative
Preoperative CT
Zovuta Inventory
1.
Vuto loyamba lomwe liyenera kukumana nalo pa njirayi ndiloti wodwalayo angathe kupirira bwinobwino opaleshoniyo poganizira zaka zake 70 zakubadwa, chotupa choopsa komanso kudwala kwake.
2.
Vuto lachiwiri ndilakuti opareshoniyi imakhudzanso kuchotsa chotupa chachikulu ndikumanganso mwendo, nthawi yayitali yochita opaleshoni, kutulutsa magazi kwakukulu komwe kungayambitse kukomoka kwa hemorrhagic, komanso kuthekera kwakukulu kwa matenda.
3.
Gawo lakutali la femur, lomwe silinawonongeke, ndi lalifupi kwambiri kuti ligwire pini ya medullary ya prosthesis, kotero momwe mungapangire pulojekiti yotetezeka komanso yothandiza yomanganso ndi vuto lachitatu.
4.
Popeza kuti zigawo zapamwamba ndi zapakati za chikazi zinasinthidwa ndikuchotsa fupa lapamwamba ndi lapakati lachikazi (kuphatikizapo mutu wa chikazi) ndipo minofu imayimitsa yomwe imayendetsa mgwirizano wa m'chiuno, momwe mungapangirenso minofu yofewa kuzungulira prosthesis ndi kubwezeretsa ntchito ya chiwalo. linali vuto lachinayi pa opaleshoniyi.
Dr. Zhang Guofeng, wachiwiri kwa dokotala wamkulu wa opaleshoni, poyamba analankhula ndi gulu la akatswiri opanga chotupa cha LDK kuti apange chotupa chopangidwa mwamakonda.Chifukwa cha kuchuluka kwa opaleshoniyi komanso zovuta komanso kuopsa kwa opaleshoniyo, kukambirana ndi kukambirana kwamitundu yambiri kunakonzedwa ndi akatswiri ochokera ku Dipatimenti ya Pathology, Dipatimenti ya Zithunzi, Dipatimenti ya Respiratory Medicine, Dipatimenti ya Cardiovascular Medicine, Oncology Center ndi Dipatimenti ya Anesthesiology kuti iwunike momwe zilili komanso kudziwa dongosolo lamankhwala.
Prosthesis Design Solution
1).Kumanganso kwa 3D kwa data yazithunzi Kumanganso kwa fupa la 3D lachitsanzo cha fupa la wodwalayo potengera zomwe amajambula.
2).Dongosolo la mapangidwe a prosthesis ndi zotsatira zake pambuyo posinthidwa
m'malo zotsatira chitsanzo
Ma prosthesis mwamakonda ndi resected chotupa zigawo
Pambuyo pokonzekera bwino, ndi mgwirizano wapang'onopang'ono wa ogwira ntchito zachipatala ndi unamwino wa dipatimenti ya opaleshoni ndi chipinda cha opaleshoni, Dr. Zhang Guofeng, wachiwiri kwa dokotala wamkulu wa opaleshoni, adachita bwino "chotupa chapamwamba ndi chapakati cha chikazi chochotsa chotupa chopangidwa ndi chotupa" wodwala.
X-ray pambuyo pa opaleshoni
Opaleshoniyo inkachitika kuti akwaniritse zolinga zochotsa fupa la chotupa, kuchepetsa ululu wa wodwalayo, kubwezeretsanso ntchito ya ziwalo ndikuwongolera moyo kwambiri.Pambuyo pozindikira komanso kusamalidwa ndi onse ogwira ntchito zachipatala ndi anamwino a Dipatimenti ya Bone Oncology, wodwalayo adachira bwino kwambiri ndipo adatulutsidwa m'chipatala.Kupweteka koopsa kwa ntchafu yomwe yakhala ikuvutitsa wodwalayo kwa nthawi yaitali inathetsedwa, ndipo wodwalayo adayambanso kuyenda bwino pambuyo pa opaleshoniyo ndipo anali wokhutira kwambiri ndi zotsatira za mankhwala.
Malangizo ochokera kwa Dr. Zhang Guofeng, Wachiwiri kwa dokotala wamkulu
Zotupa zambiri zowopsa zimatha kuyambitsa ma metastases a mafupa.Mafupa a metastases amakhala ndi ululu wam'deralo monga chiwonetsero chachikulu chachipatala, chomwe chimakhala chobisika komanso chosazindikirika pakapita nthawi, ndipo chingayambitse kuwonongeka kwakukulu kwa fupa komanso ngakhale kuthyoka kwa mafupa.Poyamba, odwala nthawi zambiri amalakwitsa ngati nyamakazi wamba, koma pambuyo pake imayamba kupweteka kwambiri, makamaka kupweteka kosalekeza kwausiku.Apa tikukumbutsani makamaka kuti zizindikiro zomwe zili pamwambazi zikuwonekera, ndikofunikira kupita kuchipatala nthawi zonse kuti mukalandire chithandizo chamankhwala munthawi yake, ndipo ngati kuli kofunikira, mayeso a X-ray, CT ndi MRI atha kuchitidwa kuti azindikire matenda ambiri amtundu wa chigoba.Mukaganiziridwa kuti ma metastases am'fupa, ndikofunikira kupita ku malo apadera a chotupa cha mafupa kuti mukawone ndi kulandira chithandizo.
Nthawi yotumiza: Oct-24-2022