Uguquko olukhulu kwiPinhole eNcinci - Ukubonwa okuPheleleyo koMnqopho weTekhnoloji ye-Endoscopy

Kutshanje, uGqr. Cong Yu, iSekela likaGqirha oyiNtloko kwiSebe le-Orthopedics kwiSibhedlele saseMpuma yeTheatre Command General, wenza "utyando lwe-spinal endoscopic olubonwa ngokupheleleyo" kuMnu. Zong. Utyando oluncinci kakhulu lwenze ukuba uMnu. Zong, owayenezifo ze-lumbar spine, alulame ngokukhawuleza kwaye abuyele emsebenzini kungekudala emva kotyando.

Andizange ndilindele ukuba umphumo wotyando ube mhle kangaka. Ndandiziva kulula ukuthomalalisa uxinezeleko lwemithambo-luvo ngexesha lotyando,” watsho ngovuyo uMnu. Zong, oneminyaka engama-56 ubudala.

Kuxelwa ukuba uMnu Zong wayeneempawu zentlungu ephantsi kunye nomlenze we-5 kwiminyaka edlulileyo. Emva kokutyelela oogqirha abadumileyo kwiindawo ezahlukahlukeneyo, iingcali ngamxhelo mnye zancomela ukuba atyandwe. Ngenxa yokoyika utyando, imeko kaMnu. Zong iye yalibaziseka ixesha nexesha kwakhona. Kwiinyanga ezintathu ezidlulileyo, iintlungu zakhe ezingaphantsi komqolo zaba mbi kwakhona, zikhatshwa ziintlungu ezinganyamezelekiyo kwilungu lakhe lasekhohlo. Wayengakwazi ukuhamba engakwazi nokulala eqaqanjelwa naxa elele, nto leyo eyayinganyamezeleki. Waphinda wafuna unyango kwizibhedlele ezininzi, enethemba lokufumana unyango oluncinci lweempawu zakhe zokungakhululeki. Ekugqibeleni, wafika kwikliniki yeengcali zotyando lomqolo kaGqr. Emva kokufumana isigulane, uDkt Cong Yu wahlalutya iimpawu zikaMnu Zong, iimpawu, kunye neenkcukacha zokucinga, kwaye wenza ukuxilongwa kwe-lumbar disc herniation kunye ne-spinal stenosis. Ngokusekelwe kwimeko kaMnu Zong kunye nokuzimisela kwakhe unyango lotyando, wamkelwa kwiSithili se-Orthopedics 23.

Emva kokungeniswa, uvavanyo lomzimba lubonise ukuba uMnu. Zong wayenomdla kwindawo ye-paraspinal ukusuka kwi-L5 ukuya kwi-S1, kunye nokunciphisa okubalulekileyo kwi-lumbar uluhlu lwentshukumo kunye nomsebenzi ophantsi wemoto. Uvavanyo lokuphakama komlenze othe ngqo lwangaphambi kokuhlinzwa lwalungama-20 ° kuphela, kwaye ukomelela kwezihlunu zozwane lwakhe lwasekhohlo nako kuchaphazelekile.

Ngokuphathelele imeko kaMnu Zong, uMlawuli uCong Yu wahlalutya ukuba i-nucleus pulposus evelele idibaniswe nokwanda kwe-osteophyte ixinzelela iintsholongwane kwi-spinal canal, okubangelwa iimpawu ezifana neentlungu ezisezantsi kunye nomlenze, ukuphazamiseka, kunye nokunciphisa amandla angaphantsi. Kuphela ngokunciphisa ukunyanzeliswa kwe-nerve sinokuthi sithintele ukunyanzeliswa komonakalo we-nerve kunye nokubonelela ngeemeko zokubuyisela umsebenzi we-nerve. Ukuba iindlela zotyando zemveli zisetyenzisiwe, kuyimfuneko ukususa izihlunu zeparaspinal, kwaye utyando lotyando lukhulu, kunye nokopha okugqithisileyo kwe-intraoperative kunye nexesha elide lokubuyisela emva kotyando.

Emva konxibelelwano olwaneleyo kunye nokulungiselela kwangaphambili, uDkt. Cong Yu wagqiba ngempumelelo utyando phantsi kwe-anesthesia yendawo usebenzisa "I-Full Visualization Spinal Endoscopy Technology (Ndiyabona)". Ngethuba lotyando, uMnu. Zong wayekwazi ngokucacileyo ukukhululeka kweentlungu eziziswa kukususwa kwe-nucleus pulposus ephumayo. Ixesha lotyando lalifutshane, ukusika kwakuyimilimitha ezi-7 kuphela, kwaye kwakungekho manzi emva kotyando. Wakwazi ukujikeleza ngosuku lwesibini emva kotyando, olunokuthi luchazwe ngokuthi "i-pinhole encinci yokuxazulula ingxaki enkulu".

Unyango olungephi lwezifo zomqolo kwisebe le-orthopedics le-Eastern Theatre Command General Hospital luphawu lobuchwephesha. Ubuchwephesha obungenabuncinci obufana ne-intervertebral foramen endoscopy, i-UBE, kunye ne-MisTLIF ziye zenziwa ngokuqhelekileyo, zidibaniswe novavanyo oluthile lwemeko yesigulane, ukubonelela ngeendlela ezininzi zonyango lotyando. Siza kuqhubeka nokusebenzisa ubuchwephesha obungangeneleliyo ukubonelela ngeenkonzo zonyango ezikumgangatho ophezulu, eziphucukileyo, kunye nezamayeza kuluntu ngokubanzi.

Ngokumalunga neTekhnoloji yeTekhnoloji ye-Visualization ye-Spinal Endoscopy (Ndiyayibona iTekhnoloji)

I-Minimally Invasive Spine Surgery (MISS) ibhekisela kwithekhnoloji kunye neendlela zokuxilonga kunye nokunyanga izifo zomgogodla ngeendlela ezingezizo ezemveli kunye nokusebenzisa izixhobo ezikhethekileyo zotyando, izixhobo, okanye iindlela. Ivele ngokusetyenziswa kobona buchwepheshe buphambili bezonyango, ubugcisa obutsha buyaqhubeka nokuvela, kunye neendlela ezingephi ziyamangalisa. Kukho isixhobo esinamandla kwi-arsenal enkulu ye-MISS, eyi-percutaneous endoscopic lumbar discectomy (PELD), efinyeziweyo njenge-intervertebral foramen endoscope.

Isikolo sendabuko se-intervertebral foramen iteknoloji ye-endoscopy iye yaphuhliswa kwingcamango yokungenelela, ngoko ke inkqubo yokubeka i-tube yokubhoboza kunye nokubunjwa kwe-intervertebral foramen ixhomekeke kakhulu kwi-X-ray fluoroscopy ukucacisa indawo yendawo, enzima kwaye ichaphazela ngokunzulu izigulane kunye noogqirha nge-ray-ray.

Kwaye ndiyabona iteknoloji, eyaziwa ngokuba yi-teknoloji ye-spinal endoscopic ebonakalayo ngokupheleleyo, ivumela ukubonwa ngokuthe ngqo kwe-intervertebral foramen formation phantsi kwe-endoscopy, ukunciphisa kakhulu inani leembono kunye nokufezekisa iimbono ze-1-2. Uphawu lwale teknoloji lutshintsho kwifilosofi yotyando: ukusebenzisa utyando lwe-endoscopic njengendlela yokuhlinzwa, ukufezekisa i-endoscopization efanelekileyo yeenkqubo zotyando. Ukulahla ukungonakali kwe-intervertebral foramen endoscopic intervention intervention yendabuko efuna i-fluoroscopy ephindaphindiweyo.

Ngokubanzi, izibonelelo zetekhnoloji ye-spinal endoscopic ebonwa ngokupheleleyo (Ndibona itekhnoloji) zezi zilandelayo:

1. Ukunciphisa kakhulu i-X-ray fluoroscopy ngexesha lotyando, ukunciphisa ixesha lotyando, ukuphucula ukhuseleko lotyando, kunye nokukhusela izigulane kunye noogqirha;

2. I-anesthesia yendawo ingasetyenziselwa, elula, kunye ne-incision yokuhlinzwa engaphantsi kwe-1 centimeter kunye nokuphuma kwegazi okuncinci. Ihlasela kancinci kwaye ayifuni manzi emva kotyando. Ngosuku lwesibini emva kokuhlinzwa, isigulane sinokuhamba kwaye sikhutshwe, sinciphise ukuhlala esibhedlele kwaye sivumele isigulane ukuba sibuyele ebomini kwaye sisebenze ngokukhawuleza;

3. Ukugcina amacandelo entshukumo ye-lumbar spine; Ukungonakalisi i-lumbar facet joints, ukuphepha ukungazinzi kwe-postoperative yamacandelo otyando oluhambelanayo;

4. Le teknoloji inikezela ngamathuba onyango kwizigulane ezininzi ezingakwazi ukunyamezela utyando oluvulekileyo okanye i-anesthesia jikelele (izigulane ezisebekhulile, abo banezifo ezinzulu eziphantsi);

5. Ixabiso eliphantsi, ixabiso eliphantsi, ukonga kakhulu iindleko ze-inshurensi yezonyango.