Tsis ntev los no, Dr Zhang Guofeng, Tus Lwm Thawj Coj Tus Kws Kho Mob ntawm Lub Tsev Haujlwm Saib Xyuas Pob Txha Oncology, Yantai Affiliated Tsev Kho Mob ntawm Binzhou Medical College, thiab nws pab neeg tau ua tiav siv LDK cov qog nqaij hlav prosthesis thiab ua qhov nyuaj heev "kev cai-ua femoral qog prosthesis hloov" phais. ntawm tus neeg mob uas muaj kev nyuaj siab, uas tsis yog tsuas yog cim qhov kev txhim kho ntawm Lub Tsev Haujlwm Saib Xyuas Pob Txha Oncology, Yantai Affiliated Tsev Kho Mob ntawm Binzhou Medical College, hauv kev kho mob ntawm cov pob txha mob qog nqaij hlav, tab sis kuj tau sawv cev rau nws cov kev phais mob qib siab tau mus txog qib siab hauv tsev. .
Kev piav qhia ntawm tus mob
Tus neeg mob, poj niam, hnub nyoog 70
Ib xyoos dhau los tus neeg mob tau tsim cov tsos mob ntawm nws sab xis sab xis, uas maj mam zuj zus.Tus neeg mob xav tias nws muaj femoral lub taub hau necrosis, tab sis qhov mob tseem mob siab tom qab noj tshuaj tua kab mob.Tsis ntev los no, nws tau sab laj Yantai Affiliated Tsev Kho Mob ntawm Binzhou Medical College txij li qhov mob hnyav heev uas nws pw tsis taus hmo ntuj lossis taug kev ntxiv lawm.
MRI ntawm nws qhov kev sib koom ua ke tau qhia txog qhov txawv txav ntawm qhov kawg ntawm txoj cai femur, thiab cov qog nqaij hlav raug txiav txim siab.Tom qab ntawd tus neeg mob tau mus rau Department of Bone Oncology rau kev kho mob ntxiv.
Tom qab kev soj ntsuam kom ntxaws, pab neeg ntawm tus thawj kws kho mob Zhang Guofeng tau lees paub qhov kev kuaj mob ntawm metastatic qog nyob rau hauv txoj cai femur, thiab thawj qhov txhab raug suav hais tias yog mob qog noj ntshav peripheral.Tom qab tag nrho kev sib txuas lus nrog tus neeg mob thiab nws tsev neeg, kev phais tau txiav txim siab.
Kev Sib Tw Txais!Kev kho mob-kev lag luam kev koom ua ke rau kev nyuaj hloov kev phais
Qhov teeb meem nyuaj tshaj plaws rau cov kws kho mob yog tias tus neeg mob muaj hnub nyoog 70 xyoo thiab sab xis sab sauv thiab nruab nrab femur tau raug rhuav tshem los ntawm cov qog nqaij hlav, txawm tias lub plab femur uas tsis tau raug eroded tsis tshuav ntau, yog li cov qauv kev tsim kho dua qub tom qab qog. resection twb tsis siv lawm.Tom qab rov simulations thiab kev sib tham, Dr. Zhang Guofeng pab neeg txiav txim siab los ua cov qog resection ntawm lub qaum thiab nruab nrab femur + kho cov qog prosthesis hloov.
Preoperative MRI
Preoperative CT
Cov khoom muag nyuaj
1.
Thawj qhov nyuaj yuav tsum tau ntsib rau cov txheej txheem no yog seb tus neeg mob puas tuaj yeem tiv taus qhov kev phais kom zoo thaum nws muaj hnub nyoog 70 xyoo, qog nqaij hlav thiab lub cev tsis zoo.
2.
Qhov teeb meem thib ob yog tias kev ua haujlwm cuam tshuam nrog kev txiav tawm ntau ntawm cov qog thiab rov tsim kho ntawm cov ceg, lub sijhawm ua haujlwm ntev, los ntshav loj heev uas yuav ua rau hemorrhagic shock, thiab muaj feem ntau ntawm kev kis kab mob.
3.
Lub distal ntu ntawm lub femur, uas tsis yog eroded, yog luv heev los tuav lub medullary tus pin ntawm lub prosthesis, yog li yuav ua li cas los tsim kom muaj kev nyab xeeb thiab zoo prosthesis rau kev tsim kho yog qhov kev sib tw thib peb.
4.
Txij li thaum lub sab sauv thiab nruab nrab femoral ntu tau hloov los ntawm kev tshem tawm cov pob txha sab sauv thiab nruab nrab femoral (xws li lub taub hau femoral) thiab cov leeg tsis ua haujlwm uas ua rau lub duav sib koom ua ke, yuav ua li cas rov tsim cov ntaub so ntswg nyob ib ncig ntawm lub prosthesis thiab rov ua haujlwm ntawm cov ceg. yog qhov kev sib tw thib plaub hauv qhov kev phais no.
Dr. Zhang Guofeng, tus lwm thawj kws phais neeg, thawj zaug sib tham nrog pab neeg ntawm LDK qog prosthesis engineers los tsim ib tug customized qog prosthesis.Vim tias qhov siab ntawm qhov kev phais no thiab qhov nyuaj nrog rau kev pheej hmoo ntawm kev ua haujlwm, kev sib tham sib tham thiab kev sib tham tau raug teeb tsa nrog cov kws tshaj lij los ntawm Department of Pathology, Department of Imaging, Department of Respiratory Medicine, Department of Cardiovascular Medicine, Oncology Center thiab Department of Anesthesiology soj ntsuam tus mob thiab txiav txim siab txoj kev kho mob.
Prosthesis Design Solution
1).3D reconstruction ntawm cov duab cov ntaub ntawv 3D reconstruction ntawm tus neeg mob lub pob txha qauv raws li cov duab cov ntaub ntawv.
2).Prosthesis tsim txoj kev npaj thiab cov qauv nyhuv tom qab hloov
hloov cov nyhuv qauv
Customized prosthesis thiab resected qog ntu
Tom qab kev npaj txhij txhua, nrog rau kev sib koom tes ntawm cov kws kho mob thiab cov neeg ua haujlwm saib xyuas neeg mob ntawm lub chaw tshuaj loog thiab chav ua haujlwm, Dr. Zhang Guofeng, tus thawj coj kws phais neeg tau ua tiav "sab sauv thiab nruab nrab femoral qog resection + kho cov qog prosthesis hloov" rau lub tus neeg mob.
Postoperative X-Ray
Kev ua haujlwm tau ua kom tau raws li lub hom phiaj ntawm kev tshem tawm cov pob txha qog, txo tus neeg mob qhov mob, rov ua haujlwm ntawm ceg ceg thiab txhim kho lub neej kom zoo tshaj plaws.Tom qab ua tib zoo kuaj xyuas thiab saib xyuas los ntawm txhua tus kws kho mob thiab kws saib xyuas neeg mob ntawm Department of Bone Oncology, tus neeg mob tau zoo heev thiab raug tso tawm hauv tsev kho mob.Qhov mob hnyav ntawm tus ncej puab uas tau thab tus neeg mob rau lub sijhawm ntev tau daws, thiab tus neeg mob rov ua haujlwm li qub tom qab kev ua haujlwm thiab txaus siab heev rau kev kho mob.
Cov lus qhia los ntawm Dr. Zhang Guofeng, Tus Lwm Thawj Coj Tus Kws Kho Mob
Feem ntau cov qog malignant tuaj yeem tsim cov pob txha metastases.Cov pob txha metastases muaj qhov mob hauv zos ua qhov tshwm sim tseem ceeb hauv kev kho mob, uas yog insidious thiab tsis yooj yim nrhiav tau nyob rau hauv lub sij hawm, thiab tuaj yeem yooj yim ua rau cov pob txha puas loj thiab txawm tias cov kab mob puas.Thaum pib, cov neeg mob feem ntau yuam kev rau kev mob caj dab, tab sis tom qab ntawd nws ua rau mob hnyav, tshwj xeeb tshaj yog mob hmo ntuj.Ntawm no peb nco ntsoov tshwj xeeb tshaj yog tias thaum cov tsos mob saum toj no tshwm sim, nws yog ib qho tsim nyog yuav tsum tau mus rau hauv tsev kho mob tsis tu ncua rau kev kho mob raws sij hawm, thiab yog tias tsim nyog, X-ray, CT thiab MRI tuaj yeem kuaj xyuas kom pom feem ntau ntawm cov kab mob qog nqaij hlav.Thaum xav tias cov pob txha metastases, nws yog ib qho tseem ceeb uas yuav tsum tau mus rau qhov chaw tshwj xeeb ntawm pob txha qog rau kev sab laj thiab kho.
Post lub sij hawm: Oct-24-2022