Muva nje, uDkt Zhang Guofeng, iPhini likaDokotela Oyinhloko woMnyango Wezempilo Yamathambo, Isibhedlela Esihlobene Ne-Yantai sase-Binzhou Medical College, nethimba lakhe basebenzise ngempumelelo i-LDK eyenziwe ngokwezifiso isimila prosthesis futhi benza ukuhlinzwa okunzima kakhulu "okwenziwe ngokwezifiso kwe-femoral tumor prosthesis" ukuhlinzwa. esigulini esinesimo esiyinkimbinkimbi, esingagcinanga ngokuphawula intuthuko yoMnyango Wezempilo Yamathambo, iYantai Affiliated Hospital of Binzhou Medical College, ekwelapheni isimila esiyingozi samathambo kodwa futhi emele amakhono ayo okuhlinza asezingeni eliphezulu asefinyelele ezingeni eliphezulu lasekhaya. .
Incazelo yesimo
Isiguli, owesifazane, oneminyaka engama-70
Ngonyaka odlule isiguli saba nezimpawu ezibuhlungu ethangeni laso lesokudla, ezaba zimbi kancane kancane.Isiguli sasicabanga ukuthi sine-necrosis yekhanda lesifazane, kodwa ubuhlungu baqhubeka bunamandla ngemva kokuthatha amaphilisi ezinhlungu.Muva nje, uthintane neYantai Affiliated Hospital yase-Binzhou Medical College njengoba izinhlungu zaba nzima kangangokuthi wayengasakwazi ukulala ebusuku noma ukuhamba.
I-MRI yelunga lakhe iphakamise isignali eningi engavamile ekugcineni kwe-femur engakwesokudla, futhi isilonda sesimila sacatshangelwa.Isiguli sibe sesingeniswa eMnyangweni we-Bone Oncology ukuze siqhubeke nokwelashwa.
Ngemva kokuhlolwa okuningiliziwe, ithimba lesekela likadokotela omkhulu uZhang Guofeng likuqinisekisile ukutholakala kwesimila se-metastatic ku-femur engakwesokudla, futhi isilonda esiyinhloko sabhekwa njengomdlavuza wamaphaphu we-peripheral.Ngemva kokuxhumana okuphelele nesiguli nomkhaya waso, kwanqunywa ukuhlinzwa.
Inselele Yamukela!Medical-industrial Integration for nzima ukuhlinzwa esikhundleni
Inkinga enzima kakhulu kodokotela yayiwukuthi isiguli sasineminyaka engu-70 ubudala futhi i-femur engenhla nephakathi kwesokudla yayicekelwe phansi kakhulu ukuguguleka kwe-tumor, ngisho ne-distal femur engazange iguguleke ayizange ishiywe kakhulu, ngakho-ke izindlela ezivamile zokwakha kabusha ngemva kwesimila. ukukhishwa kabusha kwakungasasebenzi.Ngemva kokulingisa nokuxoxisana okuphindaphindiwe, ithimba likaDkt. Zhang Guofeng lanquma ukwenza isimila kabusha se-femur engenhla nephakathi nendawo + i-tumor prosthesis eyenziwe ngokwezifiso esikhundleni.
I-MRI yangaphambi kokuhlinzwa
I-CT yangaphambi kokuhlinzwa
Ubunzima Inventory
1.
Ubunzima bokuqala okumelwe kubhekwane nabo kule nqubo ukuthi isiguli singakwazi yini ukubekezelela ngokuphepha ukuhlinzwa uma sicabangela iminyaka yaso engu-70 ubudala, isimila esiyingozi nesimo somzimba esingesihle.
2.
Ubunzima besibili ukuthi ukuhlinzwa kuhilela ukukhishwa kabusha okubanzi kwesimila nokwakhiwa kabusha kwesitho, isikhathi eside sokuhlinzwa, ukopha okukhulu okungase kubangele ukushaqeka okopha, kanye namathuba aphezulu okutheleleka.
3.
Ingxenye ekude ye-femur, engaguguleki, imfushane kakhulu ukubamba iphinikhodi ye-medullary ye-prosthesis, ngakho-ke indlela yokuklama i-prosthesis ephephile nephumelelayo yokwakhiwa kabusha kuyinselele yesithathu.
4.
Njengoba izingxenye ze-femoral ezingenhla neziphakathi zathathelwa indawo ngokususa izicubu zethambo zesifazane ezingenhla naphakathi (kuhlanganise nekhanda lesifazane) kanye nezitobhi zemisipha ezishayela i-hip joint, indlela yokwakha kabusha izicubu ezithambile ezizungeze i-prosthesis nokubuyisela ukusebenza kwesitho somzimba. kwakuyinselele yesine kulokhu kuhlinzwa.
UDkt. Zhang Guofeng, iphini likadokotela ohlinzayo, uqale waxhumana nethimba lonjiniyela be-LDK bokwenziwa kwesimila ukuze bakhe isimila sokwenziwa ngendlela oyifisayo.Ngenxa yezinga eliphezulu lalokhu kuhlinzwa nobunzima kanye nobungozi bokuhlinzwa, ukubonisana nokuxoxisana kwezinhlanga ezahlukene kwahlelwa nochwepheshe boMnyango Wezifo Zomzimba, uMnyango Wezithombe, uMnyango Wezokwelapha Zokuphefumula, uMnyango Wezokwelapha zenhliziyo, i-Oncology Centre kanye UMnyango Wezokubulala Izinzwa ukuze uhlaziye isimo futhi unqume uhlelo lokwelapha.
Isixazululo se-Prosthesis Design
1).Ukwakhiwa kabusha kwe-3D kwedatha yesithombe Ukwakhiwa kabusha kwe-3D kwemodeli yamathambo esiguli ngokusekelwe kudatha yesithombe.
2).Uhlelo lokuklama i-Prosthesis kanye nesampula yomphumela ngemva kokushintshwa
isampula yomphumela wokubuyisela
I-prosthesis eyenziwe ngokwezifiso kanye nezingxenye zesimila esenziwe kabusha
Ngemva kokulungiselela kahle, ngokubambisana okuthulile kwabasebenzi bezokwelapha nabahlengikazi bomnyango wokubulala izinzwa kanye negumbi lokuhlinza, uDkt. Zhang Guofeng, isekela likadokotela ohlinzayo omkhulu, wenze ngempumelelo "ukukhishwa kwesimila se-femoral rection + customized tumor prosthesis replacement" isiguli.
I-X-Ray ye-postoperative
Ukuhlinzwa kwenziwa ukuze kuhlangatshezwane nezinjongo zokukhipha ithambo lesimila, ukukhulula ubuhlungu besiguli, ukubuyisela ukusebenza kwezitho zomzimba kanye nokwenza ngcono izinga lokuphila ngezinga eliphezulu.Ngemva kokuxilongwa ngokucophelela nokunakekelwa yibo bonke abasebenzi bezokwelapha nabahlengikazi boMnyango Wezifo Zamathambo, isiguli salulama kahle kakhulu futhi saphuma esibhedlela.Ubuhlungu obunzima ethangeni obukade buhlupha isiguli isikhathi eside buxazululiwe, futhi isiguli saphinde saqala ukuhamba okuvamile ngemva kokuhlinzwa futhi sanelisekile kakhulu ngomphumela wokwelapha.
Amathiphu avela kuDkt. Zhang Guofeng, iPhini likaDokotela Omkhulu
Izimila eziyingozi eziningi zingakha ama-metastases amathambo.Ama-metastases amathambo anobuhlungu bendawo njengokubonakaliswa komtholampilo okuyinhloko, okucashile futhi okungatholakali kalula ngesikhathi, futhi kungabangela kalula ukubhujiswa okukhulu kwamathambo ngisho nokuphuka kwe-pathological.Ekuqaleni, iziguli zivame ukwenza iphutha njengesifo samathambo esivamile, kodwa kamuva siphenduka ubuhlungu obukhulu, ikakhulukazi ubuhlungu obungapheli ebusuku.Lapha sikhumbuza ngokukhethekile ukuthi lapho izimpawu ezingenhla zivela, kuyadingeka ukuya esibhedlela esivamile ukuze uthole ukwelashwa ngesikhathi, futhi uma kunesidingo, ukuhlolwa kwe-X-ray, i-CT kanye ne-MRI kungenziwa ukuze kutholakale izifo eziningi ze-skeletal tumor.Uma sekusolwa ama-metastases amathambo, kubalulekile ukuya esikhungweni esikhethekile sesimila samathambo ukuze uxoxisane nokwelashwa.
Isikhathi sokuthumela: Oct-24-2022