Tsis ntev los no, Liu Hucheng, tus thawj coj ntawm Lub Tsev Haujlwm Saib Xyuas Pob Txha thiab Cov Ncauj Ncauj Ncauj Lus ntawm Thawj Tsev Kho Mob ntawm Nanchang University, ua tiav "pelvic qog resection + sacral osteotomy + pelvic replacement + hip change + lumbar pedicle screw internal fixation" nrog LDK customized pelvic prosthesis. , thiab kev ua haujlwm tau zoo.
Tus neeg mob raug xa mus rau lub tsev kho mob sab nraud rau qhov mob rov qab thiab tsis xis nyob.Tom qab ua tiav cov kev kuaj mob ntawm lub duav, tus neeg mob tau pom tias muaj qhov mob osteo-malignant, tab sis nws tsis tau xyuam xim rau nws, thiab tom qab ntawd nws cov tsos mob hnyav zuj zus ntxiv thiab nws txoj kev txav mus los tau txwv.Tom qab ntawd tus neeg mob tuaj rau Department of Bone and Soft Tissue Oncology of the First Affiliated Hospital of Nanchang University rau kev kho mob.
Tom qab nkag mus rau hauv tsev kho mob thiab ua tiav cov pob txha pelvic biopsy, tus neeg mob tau kuaj mob osteosarcoma.Tom qab txoj kev npaj phais mob kom zoo tau tsim ua ke los ntawm ntau lub tuam tsev thiab kev npaj ua ntej ua tiav, Pab Pawg Thawj Coj Liu Hu Cheng tau ua "pelvic qog resection + sacral osteotomy + pelvic replacement + hip replacement + lumbar arch screw internal fixation" rau tus neeg mob.
Nqe lus piav qhia:
Tus neeg mob, poj niam, 52 xyoo
Kev tsis txaus siab:
Ntau tshaj 3 lub hlis tom qab kws khomob rau pelvic pob txha osteosarcoma
Tam sim no kev kho mob keeb kwm:
Tus neeg mob yws yws tias xyoo 2022-10, tsis muaj qhov pom tseeb ua rau muaj qhov mob rov qab qis thiab tsis xis nyob, nrog mob thiab o, nrog rau qhov mob ntawm sab laug sab laug, nyob rau sab laug sab laug, sab laug sab laug, sab nraub qaum. ntawm tus ncej puab, sab nraub qaum ntawm tus nyuj mus rau sab laug ko taw, loog hauv qab ntawm sab laug ko taw, qhov mob tau nce ntxiv tom qab lub sijhawm ntev thiab taug kev, thiab tuaj yeem txo tau thaum so, thaum tsis muaj kev mloog, thiab tom qab ntawd Cov tsos mob mob pib nce thiab taug kev tsis tau.
MRI qhia tias: 1) txawv txav teeb liab ntawm sab laug iliac pob txha, xav txog qhov muaj peev xwm ntawm malignant lesion;2) cov kua dej me me ntawm sab laug sab laug pob qij txha.Tsis muaj kev kho tshwj xeeb, thiab tam sim no tus neeg mob tau mus rau hauv tsev kho mob rau kev kho mob ntxiv.
Kev kuaj mob:
"Post-chemotherapy myelosuppression" nkag
Cov txheej txheem npaj yog "pelvic qog resection + sacral osteotomy + pelvic hloov + hip hloov + sab hauv kho nrog lumbar pedicle ntsia hlau"
Cov qauv xa mus kuaj:
Cov qog nqaij hlav sab laug tau raug xa mus kuaj: cov pob txha tsis zoo, qhov loj 19.5X17X9 cm, nrog cov leeg nqaij txuas, loj 16.5X16X3.5 cm, ntau ntu ntu, 1.5 cm los ntawm cov npoo cautery, ib qho loj tau pom hauv cov leeg nqaij. , loj 8X6.5X4.5 cm, greyish grey-liab, tawv, thiab delineated tsis zoo ntawm lub focal cheeb tsam thiab cov pob txha cov ntaub so ntswg.
Sab laug sciatic paj hlwb: grey-liab tsis zoo li cov ntaub so ntswg, loj 9.5X3X3m, grey-dawb grey-liab tawv tawv ntawm qhov chaw txiav.
Microscopically, cov qog pom cov khoom lamellar faib, invading lub peripheral fibrofat, transverse nqaij thiab paj hlwb, nrog irregularly zoo li lub hlwb, pom tseeb nucleoli, yooj yim pom nuclear schizophrenia, pom tseeb heterotypes thiab ntau necrosis.
Pathological kev kuaj mob:
(Sab laug pelvis) Ua ke nrog kev kho mob, kev tshuaj xyuas thiab keeb kwm, nws tau ua raws li cov lus teb tom qab kws khomob rau qib siab osteosarcoma (hom hom).
Huvos grading: Qib II (kev siv tshuaj kho mob me me, > 50% qog nqaij hlav necrosis, cov qog nqaij hlav ciaj sia).
Cov ntaub so ntswg cautery margin: tsis muaj kev cuam tshuam qhov txhab.
(sab laug sciatic qab haus huv) pom qhov txhab koom nrog: 2 lwm cov qog nqaij hlav pom, tsis pom metastasis (0/2) Immunohistochemistry qhia: CK(-) ; Vimentin (3+) ; Ki-67(75% +) ; SATB2(+) IMP3(+) ; MDM2(+) ; P16(+) ;S-100(scattered +) ;H3.3G34W(-) ;Brachyury(-) ; Desmin(-) CD68(-).
Kev npaj phais mob:
Pelvic qog resection + sacral osteotomy + pelvic hloov + hip hloov + lumbar pedicle ntsia hlau sab hauv fixation
Preoperative
Postoperative
Surgeon Taw Qhia
Prof. Hucheng Liu
Thawj Tsev Kho Mob ntawm Nanchang University Orthopedic Tsev Kho Mob
Chief, Department of Bone and Soft Tissue Oncology
Tus kws kho mob, Associate Professor, Master's supervisor
Tus Thawj Coj ntawm Pob Txha thiab Mos Cov Hniav Tumor Group, Orthopedic ceg, Jiangxi Medical Association
Tus Lwm Thawj Coj ntawm Pob Txha thiab Mos Cov Hniav Tumor Committee ntawm Jiangxi Kws Kho Mob Association Orthopedic ceg
Post lub sij hawm: Apr-26-2023