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Raba Karatun Harka |3D Buga Jagoran Osteotomy da Keɓaɓɓen Prosthesis don Gyaran Matsala ta Fada "Kwararren Keɓaɓɓe"

An ba da rahoton cewa Ma'aikatar Orthopedics da Tumor na asibitin Wuhan Union ta kammala aikin tiyata na farko na "bugu na 3D na baya da baya na kafada tare da sake gina hemi-scapula".Aikin da aka yi nasara ya nuna wani sabon tsayi a cikin kafadar haɗin gwiwa na haɗin gwiwa na asibiti da fasahar sake ginawa, yana kawo labari mai daɗi ga marasa lafiya da lokuta masu wahala.
Anti Liu, mai shekaru 56 a bana, ta sami ciwon kafadar dama shekaru da yawa da suka wuce.Yana da matukar muni a cikin watanni 4 da suka gabata, musamman da dare.Asibitin yankin ya sami "cututtukan ƙwayar cuta na gefen dama" akan fim ɗin.Ta zo Sashen Orthopedics da Tumor na asibitin Wuhan Union don jinya.Bayan tawagar Farfesa Liu Jianxiang ta karbi mara lafiya, an yi gwajin CT da MR na hadin gwiwa a kafada, kuma ciwon ya hada da humerus da scapula, tare da nau'i mai yawa.Na farko, an yi amfani da biopsy na gida don majiyyaci, kuma an tabbatar da ganewar asali a matsayin "sarcoma synovial biphasic na kafada dama".Idan akai la'akari da cewa ƙwayar cuta ce mai cutarwa kuma mai haƙuri a halin yanzu yana da mayar da hankali guda ɗaya a cikin jiki duka, ƙungiyar ta tsara tsarin kulawa na mutum don mai haƙuri-cikakken cirewar ƙarshen ƙarshen humerus da rabi na scapula, da 3D- buga wucin gadi baya kafada hadin gwiwa hadin gwiwa.Manufar ita ce a cimma nasarar gyaran ƙwayar ƙwayar cuta da sake ginawa na prosthesis, don haka maido da tsarin haɗin gwiwa na kafada na al'ada da aikin mara lafiya.
Cas1

Bayan sanar da yanayin majiyyaci, tsarin jiyya, da kuma tasirin warkewar da ake tsammani tare da majiyyaci da danginsu, da kuma samun izininsu, ƙungiyar ta fara shiri sosai don aikin tiyatar mara lafiya.Domin tabbatar da cikakken jagorancin tumo, rabin scapula yana buƙatar cire shi a cikin wannan aikin, kuma sake sake fasalin haɗin gwiwa yana da wahala ma'ana.Bayan nazarin fina-finai da nazari a hankali, da tattaunawa, farfesa Liu Jianxiang, da Dr. Zhao Lei, da Dr. Zhong Binlong sun tsara cikakken tsarin aikin tiyata, kuma sun tattauna yadda ake zayyana da sarrafa na'urar aikin tiyata tare da injiniyoyi sau da yawa.Sun kwaikwayi ƙwayar cuta osteotomy da shigarwa na prosthesis akan ƙirar 3D da aka buga, ƙirƙirar "daidaitawar sirri" ga majiyyaci - ƙirar haɗin gwiwa ta wucin gadi ta jujjuya kafada wacce ta dace da ƙasusuwansu na autologous a cikin rabo na 1: 1.
Cas2

A. Auna kewayon osteotomy.B. Zana 3D prosthesis.C. 3D buga prosthesis.D. Pre-shigar da prosthesis.
Haɗin kafaɗa na baya ya bambanta da haɗin gwiwar kafada ta wucin gadi na gargajiya, tare da farfajiyar haɗin gwiwa mai siffar siffar da aka sanya a gefen scapular na glenoid da ƙoƙon da aka sanya a kan ƙayyadaddun ƙayyadaddun humerus na kusa a cikin ƙayyadaddun ƙayyadaddun jimlar haɗin gwiwa na haɗin gwiwa.Wannan tiyata yana da fa'idodi masu zuwa: 1. Zai iya dacewa sosai da manyan lahani na ƙasusuwa da ke haifar da kumburin ƙari;2. Ramin gyaran gyare-gyaren ligament da aka riga aka yi zai iya gyara nama mai laushi da ke kewaye da shi kuma ya guje wa rashin daidaituwa na haɗin gwiwa wanda ya haifar da resection na rotator cuff;3. Tsarin trabecular bio-mimetic a kan saman prosthesis na iya inganta haɓakar ƙasusuwan da ke kewaye da nama mai laushi;4. Haɗin gwiwa na baya na baya na keɓaɓɓen na iya yadda ya kamata ya rage raguwar ɓarna bayan tiyata na prosthesis.Ba kamar maye gurbin kafada na al'ada ba, wannan tiyata kuma yana buƙatar cire dukkan kan humeral da rabin ƙoƙon scapular, da kuma sake gina kan humeral da kofin scapular gabaɗaya, wanda ke buƙatar ƙirar ƙira da fasaha na musamman.
Bayan shiri da shiri sosai a lokacin aikin tiyatar, an yi nasarar yi wa mara lafiya aikin tiyata a kwanan nan, karkashin jagorancin Farfesa Liu Jianxiang.Tawagar ta yi aiki kafada da kafada tare da gudanar da ayyuka na musamman don kammala cikakkiyar kawar da ƙwayar cuta, daidaitaccen osteotomy na humerus da scapula, shigarwa da haɗuwa da na'urar wucin gadi, wanda ya ɗauki sa'o'i 2 don kammalawa.
Cas3

D: Daidai yanke duk humerus da scapula tare da farantin jagorar yanke kashi don cire ƙari (H: Intraoperative fluoroscopy don cire ƙari)
Bayan tiyata, yanayin mai haƙuri yana da kyau, kuma sun sami damar motsawa tare da taimakon takalmin gyaran kafa a kan abin da ya shafa a rana ta biyu kuma suna yin motsin haɗin gwiwa na kafada.Rayukan X-ray masu biyo baya sun nuna matsayi mai kyau na haɗin gwiwa na kafada da kuma dawo da aiki mai kyau.
Cas4

Wannan tiyatar da ake yi yanzu ita ce shari'a ta farko a Sashen Kula da Orthopedics na Asibitin Wuhan wanda ya ɗauki jagorar yanke bugu na 3D da na'urorin da suka keɓance don keɓancewar haɗin gwiwar kafada da maye gurbin hemi-scapula.Yin nasarar aiwatar da wannan fasaha zai kawo fatan ceto ga mafi yawan marasa lafiya da ciwace-ciwacen kafada, da kuma amfana da adadi mai yawa na marasa lafiya.


Lokacin aikawa: Afrilu-28-2023