Gusangira Inyigisho |Ubuyobozi bwa 3D bwacapwe Osteotomy hamwe na Prosthesis yihariye yo kubaga ibitugu bisubiza inyuma “Private Customization”

Biravugwa ko ishami ry’amagufwa n’ibibyimba by’ibitaro by’ubumwe bwa Wuhan byasoje bwa mbere “icapiro rya 3D ryacapishijwe umuntu ku giti cye ryitwa arthroplasty hamwe na himi-scapula kwiyubaka”.Igikorwa cyagenze neza kigaragaza uburebure bushya mu bitugu ibitugu bihuza ibibyimba hamwe n’ikoranabuhanga ryo kongera kubaka, bizana inkuru nziza ku barwayi bafite ibibazo bitoroshye.
Nyirasenge Liu, ufite imyaka 56 uyu mwaka, yagize uburibwe bw'igitugu mu myaka myinshi ishize.Byarushijeho kuba bibi mu mezi 4 ashize, cyane cyane nijoro.Ibitaro byaho byasanze "iburyo bwa humeral cortical side tumor lesions" kuri firime.Yaje mu ishami ry’amagufwa n’ibibyimba by’ibitaro by’ubumwe bwa Wuhan kwivuza.Itsinda rya Porofeseri Liu Jianxiang rimaze kwakira umurwayi, hakozwe ibizamini bya CT hamwe na MR hamwe, kandi ikibyimba cyarimo hafi ya humerus na scapula, hamwe na hamwe.Ubwa mbere, biopsy ya puncture yaho yakorewe umurwayi, kandi isuzuma ry’indwara ryemejwe ko ari “biphasic synovial sarcoma yigitugu cyiburyo”.Urebye ko ikibyimba ari ikibyimba kibi kandi umurwayi kuri ubu afite intego imwe mu mubiri wose, itsinda ryateguye gahunda yo kuvura yihariye yo kuvana umurwayi burundu gukuraho iherezo ryimyanya ndangagitsina na kimwe cya kabiri cya scapula, na 3D- byacapwe artificiel reaction ibitugu hamwe gusimbuza.Ikigamijwe ni ukugera kubyimba ibibyimba no kwiyubaka kwa prothèse, bityo bikagarura imiterere isanzwe yumurwayi hamwe nigikorwa.

Nyuma yo kumenyekanisha uko umurwayi ameze, gahunda yo kuvura, hamwe n’ingaruka ziteganijwe zo kuvura umurwayi n’umuryango wabo, kandi babibemereye, itsinda ryatangiye kwitegura cyane kubaga umurwayi.Kugirango tumenye neza ko ikibyimba cyuzuye, kimwe cya kabiri cya scapula kigomba kuvaho muriki gikorwa, kandi kongera kubaka urutugu ni ingingo igoye.Nyuma yo gusuzuma neza filime, gusuzuma umubiri, no kuganira, Porofeseri Liu Jianxiang, Dr. Zhao Lei, na Dr. Zhong Binlong bakoze gahunda irambuye yo kubaga maze baganira ku bijyanye no gutunganya no gutunganya protezi hamwe na injeniyeri inshuro nyinshi.Bagereranije ibibyimba osteotomy na prothèse kuri moderi yacapwe ya 3D, bashiraho "progaramu yihariye" kumurwayi - prothèse artificiel reaction yigitugu ihuza amagufwa yabo ya autologique muburyo bwa 1: 1.

A. Gupima urwego rwa osteotomy.B. Shushanya prothèse ya 3D.C. Icapa 3D.D. Banza ushyire prothèse.
Igitugu gisubira inyuma gitandukanye nigitugu gakondo cyigitugu gisanzwe, hamwe nubuso bwa spherical joint bushyizwe kuruhande rwa glenoid hamwe nigikombe gishyirwa kumyanya ndangagitsina ya kimwe cya kabiri kibujijwe muri prostate.Kubaga bifite ibyiza bikurikira: 1. Irashobora guhuza cyane inenge nini yamagufa iterwa no kubyimba ibibyimba;2. Imyobo yabanjirije iyubakwa ya ligament irashobora gutunganya ingirabuzimafatizo zoroshye kandi ikirinda ihungabana ryatewe na rotate cuff resection;3. Imiterere ya bio-mimetic trabecular hejuru ya protezi irashobora guteza imbere kwinjiza amagufwa akikije hamwe nuduce tworoshye;4. Guhinduranya ibitugu byihariye birashobora kugabanya neza igipimo cya dislokasiyo ya nyuma ya opozisiyo.Bitandukanye no gusimbuza ibitugu bisanzwe bisanzwe, kubagwa bisaba kandi kuvanaho umutwe wose wa humeral hamwe na kimwe cya kabiri cyigikombe cya scapular, no kongera kubaka umutwe wa humeral hamwe nigikombe cya scapular nkigice cyose, bisaba gushushanya neza hamwe nubuhanga buhebuje bwo kubaga.
Nyuma yo gutegura neza no kwitegura neza mugihe cya perioperative, kubaga byakozwe neza kumurwayi vuba aha, bayobowe na Professor Liu Jianxiang.Iri tsinda ryakoranye cyane kandi rikora ibikorwa byuzuye kugirango rirangize burundu ikibyimba, osteotomie yukuri ya nyababyeyi na scapula, gushiraho no guteranya prothèse artificiel, byatwaye amasaha 2 kugirango birangire.

D: Kata neza neza igitereko cyose na scapula hamwe nisahani yo gukata amagufwa kugirango ukureho ikibyimba (H: Intraoperative fluoroscopy yo gukuramo ibibyimba)
Nyuma yo kubagwa, umurwayi yari ameze neza, kandi bashoboye kwimuka bifashishije igitereko ku gihimba cyanduye ku munsi wa kabiri maze bakora imitwe ya pasitoro.Gukurikirana X-imirasire yerekanaga umwanya mwiza wa prothèse yigitugu hamwe no gukira neza.

Ubu kubaga nubu ni bwo bwa mbere mu ishami ry’ibitaro bya Wuhan ishami ry’amagufwa ryifashisha uburyo bwo gukata bwacapwe bwa 3D hamwe na prothèse yihariye kugira ngo uhindure ibitugu hamwe na hemi-scapula.Ishyirwa mu bikorwa ry’ikoranabuhanga rizazana ibyiringiro bikiza ingingo ku barwayi benshi bafite ibibyimba bitugu, kandi bigirira akamaro abarwayi benshi.