Ndemanga Yachipatala
Kuwunika kosadziwika kwa kuchedwa kwa msana kusuntha kupita ku thoracic cavity, ndi chidwi ndi kujambula, njira zolephera zomwe zingatheke, kukonzekera kukonzanso, kutsatiridwa ndi malire a zomwe zingatheke kuchokera ku nkhani imodzi yomwe inanena.
Chidziwitso chofalitsa ndi chilolezo
Chilolezo cholembedwa chodziwitsidwa kuti chifalitsidwe ndi chilolezo chogwiritsa ntchito zithunzi zosazindikirika chinapezedwa ndipo chimasungidwa ndi wosindikiza. Zozindikiritsa za odwala, maopaleshoni komanso zipatala zachotsedwa pa intaneti iyi.
Chidule cha nkhani
Malinga ndi zomwe zidaperekedwa kuti ziwunikenso, munthu wamkulu wazaka zapakati yemwe ali ndi mbiri yakutali ya posterior thoracolumbar fusion adayambitsa kusapeza bwino pachifuwa cha pleuritic komanso dyspnea. Radiography ndi computed tomography akuti zinawonetsa kusamuka kwa cephalad kwa ndodo yayitali ya msana kupita kumanzere kwa thoracic patsekeke pambuyo pochotsedwa kumbuyo.
Kasamalidwe ka malipoti kanakhudza kuchotsedwa kwa ndodo yosamutsidwa ndikukonzanso kukhazikika kwapambuyo pa gawo limodzi la opaleshoni. Palibe zonena zambiri za ukulu wa chipangizo, mawonekedwe a ulusi, kasinthidwe ka ulalo kapena njira ya opaleshoni yomwe ingapangidwe kuchokera pankhaniyi yokha.
Kusamuka kwa msana ndi chinthu chachilendo koma chomwe chingakhale chochedwetsa kwambiri cha zida za msana. Malipoti ofalitsidwa amafotokoza za kusamukira ku ngalande ya msana, retroperitoneum, pelvis, mediastinum ndi thoracic. Njira ndi kasamalidwe koyenera zimasiyana kwambiri pakati pa milandu, ndichifukwa chake kujambula, kuphatikizika, mtundu wa mafupa, mawonekedwe omanga komanso kuyandikira kwazinthu zofunikira ziyenera kuyesedwa payekhapayekha.
Maziko a umboni ndi udindo wotsimikizira
Tsambali limalekanitsa nkhani zomwe zaperekedwa kuchokera ku mabuku azachipatala omwe angapezeke mwaokha. Kusiyanitsa kumeneko ndikofunikira: kufotokozera nkhani kumatha kuwonetsa vuto lachipatala, koma sikungakhazikitse zochitika, kutsimikizira choyambitsa kapena kuwonetsa kuti kamangidwe kamodzi kamalepheretsa kulephera kwamtsogolo.
| Mtundu wa zidziwitso |
Gwero lomwe lagwiritsidwa ntchito patsambali |
Kutsimikizika kofunikira |
| Mbiri ya mlandu ndi nthawi |
Zolemba zamilandu zimaperekedwa kwa wosindikiza |
Tsimikizirani motsutsana ndi zolemba zachipatala zomwe sizikudziwika musanasindikizidwe |
| Zithunzi za Radiographic |
Zithunzi ziwiri zoperekedwa ndi nkhani yoyambirira |
Tsimikizirani kuvomereza kwa wodwala, umwini, kusazindikiritsa komanso chilolezo chogwiritsa ntchito zithunzi |
| General chipatala maziko |
Malipoti owunikiridwa ndi anzawo omwe ali pansipa |
Owerenga akuyenera kuwunikanso zolembedwa zoyambirira ndi zolephera zake |
| Zambiri zamalonda |
Zambiri za XC Medico |
Tsimikizirani tsatanetsatane motsutsana ndi zilembo zamakono komanso zolemba zamaluso |
Nkhani yofotokozedwa
Nkhani zomwe zaperekedwa zimafotokoza za mwamuna wachikulire yemwe ali ndi zaka za m'ma 50 ndi mbiri ya posterior thoracolumbar deformity correction and fusion kuchokera ku T11 kupita ku L3 pafupifupi zaka 15 zapitazo. Zina zomwe zidanenedwazo zinali kusuta, kuwongolera kuthamanga kwa magazi komanso kuchepa kwa mafupa amchere.
Wodwalayo akuti adayamba kupweteka pachifuwa chakumanzere chakumanzere komwe kumapita kudera la scapular, kukulitsidwa ndi kudzoza kozama, komanso kufooka pang'ono kwa dyspnea kwa milungu ingapo. Palibe kuperewera kwatsopano kwa mitsempha yotsika kwambiri yomwe idanenedwa.
Lipoti lanthawi yachipatala
| Gawo |
Linanena chochitika |
Kufunika kwachipatala |
| Mbiri yakutali |
Posterior thoracolumbar fusion ndi zida |
Imakhazikitsa matenda omwe angakhalepo mochedwa chifukwa cha hardware |
| Ulaliki |
Kusapeza bwino pachifuwa cha pleuritic komanso kufooka pang'ono kochita masewera olimbitsa thupi |
Zizindikiro zidapangitsa kuwunika kwa mtima ndi zovuta zokhudzana ndi hardware |
| Kufotokozera koyamba |
Chifuwa radiograph yotsatiridwa ndi thoracic CT |
Adatanthauzira malo ndi njira ya zida zosamukira |
| Kulowererapo |
Adanenanso za kubweza zakumbuyo ndikukonzanso zomanga |
Cholinga chochotsa gawo lomwe lasamutsidwa ndikukonza zotsalazo |
| Londola |
Kuwunika kwachipatala ndi radiographic kwa miyezi itatu |
Zotsatira zazifupi zokha; sichimakhazikitsa kukhazikika kwa nthawi yayitali |
Kufotokozera zotsatira
Chilolezo chofunika Ayenera kukhala pagulu pokhapokha ngati wosindikizayo ali ndi chilolezo cholembedwa komanso kugwiritsa ntchito zithunzi ndikutsimikizira kuti ndi a mlandu womwe wafotokozedwa.
![Ma radiograph adanenedwa akuwonetsa kusamuka kwa cephalad kwa ndodo ya msana kupita ku thoracic cavity]()
Chithunzi 1. Anapereka chithunzi cha radiographic chomwe chimasonyeza kuti cephalad displacement ya longitudinal spinal rod kumtunda wa thoracic. Chithunzi chochokera, chilolezo cha odwala ndi chilolezo chofalitsa ziyenera kutsimikiziridwa musanagwiritse ntchito.
![Mawonedwe a CT omwe adanenedwa omwe amagwiritsidwa ntchito poyesa malo a hardware yosamukira pafupi ndi thoracic]()
Chithunzi 2. Kupereka mawonedwe a CT omwe adanenedwa kuti akuwonetsa malo a hardware osamutsidwa okhudzana ndi mapangidwe a thoracic. Mawu omaliza ayenera kuvomerezedwa ndi radiologist kapena gulu lachipatala.
Malingana ndi kutanthauzira komwe kunaperekedwa, ndodoyo inali itachoka kumbali ya kumanzere kwa zomangamanga zam'mbuyo ndipo inasamukira pamwamba. CT idagwiritsidwa ntchito kuwunika mgwirizano pakati pa hardware ndi pleura, mapapo ndi mitsempha yapafupi. Ubale weniweni wa anatomiki uyenera kufotokozedwa ndi dokotala wodziwa bwino yemwe adawunikiranso zojambula zoyambirirazo.
Zoganizira za kasamalidwe
Nkhani zofalitsidwa zikuwonetsa kuti kasamalidwe kamakhala kosiyana kwambiri. Zinthu zomwe zingakhudze kukonzekera zimaphatikizapo zizindikiro, mawonekedwe a kuphatikizika, umboni wa matenda kapena kusagwirizana, kukhulupirika kwa hardware, khalidwe la fupa, kayendedwe ka kusamuka komanso kuyandikira kwa neural, vascular or visceral structures.
Njira zovomerezeka zomwe zimaganiziridwa munkhani yomwe yaperekedwa
- Kuchotsa kwachindunji kwa gawo lomwe lasamutsidwa: kutha kuthana ndi vuto la hardware lomwe likubwera koma sizingothetsa kusakhazikika kapena kulephera kwina kulikonse pakumanga.
- Kuphatikizika kwa chithandizo cham'mbuyo kapena cham'mimba ndi cham'mbuyo: chikhoza kuganiziridwa pamene kuyang'ana kwachindunji kwa mapangidwe a thoracic kuli kofunikira, koma zofunikira za ndondomeko zimadalira munthu payekha ndi kufufuza kwamitundu yambiri.
- Kubwezeretsanso pambuyo pokonzanso zomanga: inali njira yomwe idanenedwa munkhani yomwe idaperekedwa. Kuyenerera kwake sikungafanane ndi njira zina zakusamuka.
Ndodo kusamuka pafupi thoracic patsekeke kungachititse chiopsezo kwa pleural, m'mapapo mwanga kapena mtima nyumba, koma mwachangu ndi opaleshoni njira ayenera kutsimikiza ndi kuchitira akatswiri. Tsambali silowongolera njira za opaleshoni.
Adanenapo za kulowererapo
Zomwe zanenedwapo Nkhani yomwe idaperekedwa imanena kuti njira yakumbuyo yam'mbuyo idatsegulidwanso, zida zotsalira zidawululidwa, ndipo ndodo yomwe idasamutsidwa idachotsedwa pathirakiti lomwe adalipo motsogozedwa ndi chithunzi. Chomangira choyambiriracho chinasinthidwanso pogwiritsa ntchito zomangira zapambuyo za pedicle, ndodo ndi zolumikizira.
Zolemba zomwe zaperekedwa zikuwonetsa nthawi yogwira ntchito ya mphindi 155 ndikuyerekeza kutaya kwa magazi kwa 210 ml. Ziwerengerozi ziyenera kusungidwa pokhapokha ngati zitsimikizidwa motsutsana ndi mbiri yosadziwika. Amalongosola ndondomeko yomwe yafotokozedwayi yokha ndipo sayenera kuperekedwa ngati zotsatira zomwe zikuyembekezeredwa pamilandu yofanana.
Nkhani yomwe idachokerako idanenanso zakuchepetsa polyaxial pedicle screw system. Owerenga omwe akufuna tsatanetsatane wazinthu zomwe si zachipatala akhoza kuwunikanso kuchepetsa pedicle screw system . Mafotokozedwe azinthu ayenera kutsimikiziridwa ndi zolemba zamakono, ndipo ulalowu sukutsimikizira kuti chinthucho ndi chomwe chinayambitsa zomwe zanenedwazo.
Lipoti la maphunziro a postoperative ndi kutsata
Nkhani yomwe yaperekedwa ikuwonetsa kusintha kwa ululu wa pachifuwa pambuyo pa opaleshoniyo, kusungidwa m'mitsempha yotsika kwambiri komanso kulimbikitsana panthawi yoyambirira ya opaleshoniyo. Ananenanso kuti kusamalidwa koyenera komanso kusintha kwa zizindikiro pakuwunika kwa miyezi itatu.
Izi ndi zowonera kwakanthawi kochepa. Mawu monga 'zero micro-motion,' 'perfect structural hold' kapena 'kulephera kuchotsedwa' achotsedwa mwadala chifukwa kujambula kotsatira sikungagwirizane ndi mfundozo.
Njira zotheka za kusamuka kwa msana
Chifukwa chenichenicho pa nkhani yoperekedwayi sichinadziwike paokha. Malipoti osindikizidwa amakambitsirana za zinthu zingapo zomwe zingathandize, kuphatikiza ndodo kapena seti-screw dissengagement, kusweka kwa chigawo, pseudarthrosis, kumangirira kosakwanira, kusalinganika kwa kupanga, kukweza mobwerezabwereza, kuchepa kwa mafupa ndi kulephera kwa kuphatikizika.
Mwachitsanzo, nkhani zofalitsidwa zimalongosola kusuntha kwa ndodo ku malo a thoracic subarachnoid, retroperitoneum, pelvis ndi pulmonary. Malipotiwa akuwonetsa kusamuka kwakutali ngati kosowa ndipo akugogomezera kulingalira ndi kutsata kwa nthawi yayitali m'malo mopereka njira imodzi yapadziko lonse lapansi.
Osanena chifukwa chimodzi
Set-screw position yokha sikutsimikizira chifukwa chomwe chomanga chinalephereka. Mkhalidwe wa fusion, kukhulupirika kwa gawo, njira ya opaleshoni ndi zinthu za odwala zimafunikiranso kuwunikiranso.
Pewani zonena za kapangidwe kake
Ma geometry a ulusi ndi zolumikizira zolumikizira zimatha kukhudza zimango, koma vuto limodzi silingatsimikizire kuti chinthucho chimachotsa kumasula kapena kusamuka.
Gwiritsani ntchito kuwunika kwanthawi yayitali
Kusamuka kwina kofalitsidwa kunachitika zaka zambiri pambuyo pa ndondomeko ya ndondomeko, kuthandizira kupitirizabe kuyang'anitsitsa kupweteka kwatsopano, zizindikiro za mitsempha kapena madandaulo osadziwika bwino a cardiopulmonary.
Kuwongolera kofananira ndi anatomy
Malo a hardware omwe anasamutsidwa okhudzana ndi neural, vascular and visceral structures angasinthe kwambiri makonzedwe ogwirira ntchito.
Zochepera pakuwunikanso mlanduwu
- Zolemba zenizeni zenizeni sizinaperekedwe kapena kuwunikira pawokha pakuwunikaku kwa SEO.
- Chilolezo cholembedwa, umwini wa zithunzi ndi chilolezo cha mabungwe ziyenera kutsimikiziridwa musanasindikizidwe.
- Uwu ndi mlandu umodzi womwe wanenedwa popanda gulu lowongolera.
- Kutsatira kumangotengera nthawi yomwe yafotokozedwa munkhani yomwe yaperekedwa.
- Mlanduwu sungathe kukhazikitsa zochitika, chifukwa, kukwera kwa chipangizo kapena kupewa kulephera kwanthawi yayitali.
- Kukhudzidwa kwa malonda ndi mafotokozedwe akuyenera kutsimikiziridwa motsutsana ndi zolemba zomwe zingapezeke ndi zolemba zamakono.
- Palibe chiganizo chamtengo wapatali chomwe chimapangidwa chifukwa mtengo wamtengo wapatali woyambirira unali wosagwirizana komanso wosachokera kunja.
Mfundo zazikuluzikulu zophunzirira
- Kusamuka kwakutali kwa msana ndikosowa koma kungaphatikizepo neural, vascular, pleural or visceral structures.
- Chifuwa chatsopano, m'mimba, m'chiuno kapena m'mitsempha mwa wodwala yemwe ali ndi zida zakutali za msana amatha kulungamitsa kuwunika kwazovuta za Hardware.
- Radiography ndi CT zitha kuthandizira kutanthauzira malo a Hardware ndikuthandizira mapulani osiyanasiyana.
- Otsogolera akuyenera kuganizira za gawo lomwe lasamutsidwa komanso momwe nyumba yotsalayo ilili.
- Chotsatira chimodzi chabwino sichitsimikizira kuti chinthucho chimalepheretsa kumangidwa kwamtsogolo.
Mafunso omwe amafunsidwa pafupipafupi
Kodi ndodo ya msana ingasamuke zaka pambuyo pa opaleshoni ya fusion?
Malipoti amilandu osindikizidwa akuwonetsa kuchedwa kwa ndodo zaka zingapo pambuyo pa kuyimba kwa msana. Zimatengedwa zachilendo, ndipo makina amasiyana pakati pa milandu.
Ndi zizindikiro ziti zomwe zingagwirizane ndi zida za msana zomwe zasamukira?
Zizindikiro zimadalira malo osamukirako ndipo zingaphatikizepo kupweteka komweko, kusintha kwa ubongo, zizindikiro za kupuma kapena zizindikiro zomwe zimayambitsidwa ndi kukwiyitsa kwa nyumba zapafupi. Zizindikiro zofananazi zimakhala ndi zifukwa zina zambiri ndipo zimafunikira kuunika kwachipatala.
Kodi cholumikizira chimalepheretsa kusuntha kwa msana?
Zolumikizana zodutsa zimatha kusintha makina omanga ndi kukhazikika kozungulira pamakonzedwe osankhidwa, koma sanganenedwe kuti athetse chiopsezo cha kusamuka. Kugwiritsiridwa ntchito kwawo kumatsimikiziridwa ndi dokotala wochita opaleshoni ndi zofunikira za kumanga.
Kodi nkhaniyi ikutsimikizira kuti pedicle screw system ndi yotetezeka?
Ayi. Mlandu umodzi sungathe kukhazikitsa chitetezo chofananira kapena kuchita bwino. Zomwezo zimafuna umboni woyenerera wamakina, wowongolera komanso wachipatala.
Onani zowonjezera maphunziro achipatala kuchokera ku XC Medico. Mlandu uliwonse uyenera kutanthauziridwa mkati mwa umboni wake, malo ovomerezeka ndi malire.
Pemphani zolembedwa zamaluso
Pamafunso ogawa kapena akatswiri, funsani zomwe zikuchitika, zolembera ndi zolemba zaukadaulo zadongosolo la msana. Zambiri zamalonda sizilowa m'malo mwachigamulo chachipatala kapena kuunikanso koyang'anira msika.
Lumikizanani ndi XC Medico
Chidziwitso chogwiritsa ntchito akatswiri: Ndemanga iyi ndi ya maphunziro ndi bizinesi ndi bizinesi. Si malangizo achipatala, malingaliro opangira opaleshoni kapena umboni wakuti chipangizo chilichonse chidzalepheretsa kusamuka kwa hardware. Zosankha zachipatala ziyenera kupangidwa ndi asing'anga oyenerera pogwiritsa ntchito zidziwitso zokhudzana ndi wodwala komanso zolemba zomwe zikuyenera kuchitika.
