E ai ki ngā pūrongo kua oti i te Tari Orthopedic and Pumpkin o te Hōhipera o Wuhan Union te pokanga tuatahi "tānga-3D whaiaro me te hanga anō hemi-scapula". Ko te pokanga angitu he tohu i tētahi taumata hou i roto i te hangarau tango me te hanga anō o te pukupuku hononga pakihiwi o te hōhipera, he mea kawe mai i ngā rongo pai ki ngā tūroro he uaua ngā take.
I pāngia a Whaea Liu, 56 tau te pakeke i tēnei tau, e te mamae o tōna pakihiwi matau i ētahi tau kua pahure. Kua tino kino haere i roto i ngā marama e 4 kua pahure ake nei, inā koa i te pō. I kitea e te hōhipera o te rohe he "ngā whara o te taha matau o te humerus cortical" i runga i te kiriata. I haere mai ia ki te Tari Orthopedics me te Pukupuku o te Hōhipera o Wuhan Union mō te maimoatanga. I muri i te whiwhinga o te tūroro e te tīma a Ahorangi Liu Jianxiang, i whakahaerehia ngā whakamātautau CT me te MR mō ngā hononga pakihiwi, ā, i uru te pukupuku ki te humerus proximal me te scapula, me te whānuitanga o te whānuitanga. Tuatahi, i whakahaerehia te biopsy poka ā-rohe mō te tūroro, ā, i whakaūtia te tātaritanga pathological ko te "biphasic synovial sarcoma o te pakihiwi matau". I te mea he pukupuku kino te pukupuku, ā, he kotahi te arotahi o te tūroro i tēnei wā i roto i te tinana katoa, i hangaia e te tīma he mahere maimoatanga takitahi mō te tūroro - te tango katoa i te pito proximal o te humerus me te haurua o te scapula, me te whakakapinga hononga pakihiwi whakamuri horihori i tāia 3D-3D. Ko te whāinga kia tutuki te tango pukupuku me te hanga anō i te prosthesis, kia whakahokia mai ai te hanganga me te mahi noa o te hononga pakihiwi o te tūroro.
I muri i te kōrero mō te āhua o te tūroro, te mahere maimoatanga, me ngā hua rongoā e tumanakohia ana ki te tūroro me tōna whānau, me te whiwhi i tā rātou whakaaetanga, ka tīmata te tīma ki te whakarite kaha mō te pokanga o te tūroro. Hei whakarite kia tino tangohia te pukupuku, me tango te haurua o te scapula i roto i tēnei pokanga, ā, he mea uaua te hanga anō i te hononga pakihiwi. Whai muri i te arotake tupato i ngā kiriata, te whakamātautau tinana, me te kōrero, ka hangaia e Ahorangi Liu Jianxiang, e Tākuta Zhao Lei, me Tākuta Zhong Binlong he mahere pokanga taipitopito, ā, ka kōrerohia te hoahoa me te tukatuka o te prosthesis me te miihini i ngā wā maha. I whakatauirahia e rātou te osteotomy pukupuku me te tāutanga prosthesis ki runga i tētahi tauira tānga 3D, ka hangaia he "whakaritenga tūmataiti" mō te tūroro - he prosthesis hononga pakihiwi whakamuri horihori e ōrite ana ki ō rātou wheua autologous i roto i te ōwehenga 1:1.
A. Inehia te whānuitanga o te osteotomy. B. Hoahoahia te prosthesis 3D. C. Tāia te prosthesis 3D. D. Tāutahia i mua te prosthesis.
He rerekē te hononga pakihiwi whakamuri i te hononga pakihiwi horihori tuku iho, ko te mata hononga porowhita e whakatakotoria ana ki te taha scapula o te glenoid me te kapu e whakatakotoria ana ki te humerus haurua-herea proximal i roto i te prosthesis hononga pakihiwi katoa haurua-herea. Ko ngā painga o tēnei pokanga: 1. Ka taea te whakataurite i ngā hapa wheua nui i puta mai i te tangohanga pukupuku; 2. Ka taea e ngā kōhao hanga hononga kua oti te hanga te whakatika i ngā kiko ngohengohe e karapoti ana, me te karo i te kore pumau o te hononga i puta mai i te tangohanga rotator cuff; 3. Ka taea e te hanganga trabecular bio-mimetic i runga i te mata o te prosthesis te whakatairanga i te tipu o te wheua me te kiko ngohengohe e karapoti ana; 4. Ka taea e te hononga pakihiwi whakamuri whaiaro te whakaiti i te tere nekehanga o te prosthesis i muri i te pokanga. Kāore i rite ki te whakakapinga pakihiwi whakamuri tuku iho, me tango hoki e tēnei pokanga te pane humerus katoa me te haurua o te kapu scapula, me te hanga anō i te pane humerus me te kapu scapula hei poraka katoa, e hiahia ana ki te hoahoa tika me te tikanga pokanga tino pai.
Whai muri i te whakamahere me te whakarite āta i te wā o te pokanga, i angitu te pokanga i te tūroro i ngā rā tata nei, i raro i te arataki a Ahorangi Liu Jianxiang. I mahi tahi te tīma, ā, i whakahaerehia ngā mahi tika hei whakaoti i te tango katoa o te pukupuku, te tango tika i te wheua o te humerus me te scapula, te tāutanga me te huihuinga o te prosthesis horihori, e rua hāora te roa o te whakaoti.
D: Tapahia tika te humerus me te scapula katoa mā te pereti arataki tapahi wheua hei tango i te pukupuku (H: Te fluoroscopy i te wā o te pokanga mō te tango i te pukupuku)
I muri i te pokanga, i pai te āhua o te tūroro, ā, i taea e rātou te neke me te āwhina o te tautoko i te peka e pāngia ana i te rua o ngā rā, me te mahi i ngā nekehanga hononga pakihiwi kore mahi. I whakaatuhia e ngā hihi-X whai muri te tūnga pai o te hononga pakihiwi me te whakaoranga pai o te mahi.
Ko te pokanga o nāianei te tuatahi o ngā mahi i roto i te Tari Orthopedic o te Hōhipera o Wuhan Union e whakamahi ana i te aratohu tapahi tānga-3D me ngā prostheses whaiaro mō te whakakapinga hononga pakihiwi whakamuri me te whakakapinga hemi-scapula. Mā te whakatinanatanga angitu o tēnei hangarau ka kawea mai he tumanako whakaora waewae ki ētahi atu tūroro he pukupuku pakihiwi, ā, ka whai hua hoki ki te tini o ngā tūroro.
Wā tuku: 28 Paenga-whāwhā 2023
