Proximal humerus fractures yog ib qho ntawm feem ntau cov pob txha pob txha nyob rau hauv kev raug mob orthopedics, thiab feem ntau proximal humerus fractures yog tsawg-zog osteoporotic fractures nyob rau hauv cov neeg laus.
Txawm hais tias feem ntau ntawm cov pob txha humerus tuaj yeem kho tau zoo, 10-15% ntawm cov pob txha puas tseem xav tau kev kho phais, uas suav nrog kev txo qis ntawm cov phaj fixation, kaw txo intramedullary ntsia thawv sab hauv kho, thiab sib koom ua ke.
Kev txiav txim siab ntawm kev kho mob yuav tsum tau ua raws li tus neeg mob lub cev, nws qhov kev xav, kev xav ntawm lub hlwb, thiab hom pob txha.
Rov kho dua thiab kho cov pob txha thaum muaj xwm ceev
【Cov Lus Pom Zoo】Rau qhov sib thooj humeral ntau dua tuberosity (NEER hom 2 ib feem ntawm pob txha) pob txha ua ke nrog lub xub pwg dislocation, kev kuaj xyuas ua ntej CT, tshwj tsis yog rau pob txha hauv cheeb tsam phais caj dab, rov tso dua thiab nres nrog kev puas tsuaj lub xub pwg brace nyob rau hauv kev siv tshuaj loog thaum muaj xwm ceev (tus kws tshaj lij pom zoo tus nqi: 7.2%).
2. Preoperative mob mob tswj
【Cov Lus Pom Zoo】 Cov neeg mob uas muaj qhov sib thooj humerus pob txha muaj kev nyiam ua ntej kev ua xua nrog rau qhov ncauj acetaminophen los yog NSAIDs, thiab qhov ncauj opioids tuaj yeem ntxiv yog tias cov nyhuv tsis zoo (tus kws tshaj lij pom zoo tus nqi: 100%; muaj zog pom zoo tus nqi: 73.8%).
3. Kev kawm ua ntej ua tub txib
[Cov Lus Pom Zoo] Kev kawm ua ntej yuav tsum tau ua kom muaj kev sib txawv thiab ntau yam. (Tus kws tshaj lij pom zoo tus nqi: 100%; tus nqi pom zoo: 83.8%)
4. Kev ntsuam xyuas khoom noj khoom haus ua ntej thiab txhawb kev kho mob
【Cov Lus Pom Zoo】 Txhawm rau ua kom tiav kev tshuaj xyuas zaub mov ntawm cov neeg mob hauv 24 teev tom qab nkag thiab muab kev pabcuam zaub mov rau cov neeg mob uas muaj kev pheej hmoo noj zaub mov. (Tus kws tshaj lij pom zoo tus nqi: 98.5%; muaj zog pom zoo tus nqi: 55.9%)
5. Perioperative glucose ntsuam xyuas thiab kev tswj hwm hauv cov neeg mob ntshav qab zib
【Cov Lus Pom Zoo】 Lub hom phiaj tswj glycemic pom zoo rau cov neeg mob ntshav qab zib feem ntau uas tau xaiv txoj kev phais yog 7.8 txog 10.0 mmol / L.
6. Kev tswj cov nqaij mos o hauv lub sijhawm perioperative
【Cov Lus Pom Zoo】 Rau cov neeg mob uas tau xaiv txoj kev phais mob rau qhov sib thooj humerus pob txha, ntau txoj kev siv lub cev tau muab los txo qhov o thaum lub sij hawm perioperative. (Tus kws tshaj lij pom zoo tus nqi: 98.5%; muaj zog pom zoo tus nqi: 80.9%)
7. Kev tswj kev noj zaub mov ua ntej
【Cov Lus Pom Zoo】 Cov neeg mob uas muaj kev xaiv phais tuaj yeem noj cov dej ntshiab 2 teev ua ntej kev phais thiab cov khoom noj starchy lossis cov khoom siv mis nyuj 6 teev ua ntej kev phais. (Tus kws tshaj lij pom zoo tus nqi: 100%; tus nqi pom zoo: 76.5%)
8. Perioperative urinary catheter tswj
【Cov Lus Pom Zoo】 Kev niaj hnub perioperative urinary catheterization tsis pom zoo rau kev phais mob pob txha pob txha (tus kws tshaj lij pom zoo: 100%; Muaj zog pom zoo tus nqi: 78.6%)
9. Kev siv tshuaj tiv thaiv kab mob perioperative antimicrobial
【Cov Lus Pom Zoo】Rau cov neeg mob uas muaj qhov sib thooj humerus pob txha uas xav tau endoprosthesis lossis kev sib koom ua ke, kev siv tshuaj tiv thaiv ntawm thawj- thiab thib ob tiam cephalosporins raug pom zoo rau kev tiv thaiv kab mob hauv lub sijhawm perioperative. (Tus kws tshaj lij pom zoo tus nqi: 97.1%; muaj zog pom zoo tus nqi: 73.5%)
10. Kev xaiv tshuaj loog
【Cov Lus Pom Zoo】 Cov tshuaj loog raug pom zoo kom siv cov txheej txheem hauv cheeb tsam thaiv cov tshuaj loog hauv cheeb tsam, xaiv cov tshuaj kom tsis txhob ua rau lub cev tsis ua haujlwm ntawm cov neeg laus, thiab ua tib zoo saib xyuas kom muaj zog saib xyuas (tus kws tshaj lij pom zoo: 100%; muaj zog pom zoo tus nqi: 71.4%).
11. Intraoperative ntshav siab contro
[Cov Lus Pom Zoo] Kev txo qis ntawm cov ntshav siab yuav tsum tau ua tib zoo saib xyuas kom txo qis cov ntshav tsis txaus rau qhov sib thooj humeral fractures, tab sis cov neeg laus cov neeg mob uas muaj ntau yam comorbidities yuav tsum tau xyuam xim rau kev tswj cov hemodynamic stability kom tsis txhob muaj qhov tsis txaus ntawm cov ntaub so ntswg thiab lub cev (tus kws tshaj lij pom zoo tus nqi: 100%; muaj zog pom zoo tus nqi: 61.9%).
12. Intraoperative ntim tswj
[Cov Lus Pom Zoo] Ua raws li lub hom phiaj ntawm kev tswj cov kua dej, thiab cov tshuaj vasoactive tuaj yeem muab tshuaj tiv thaiv thaum lub sij hawm siv tshuaj loog kom tsis txhob muaj dej ntau dhau (tus kws tshaj lij pom zoo: 100%; tus nqi pom zoo: 69.1%).
13. Intraoperative ntshav tswj
[Cov lus pom zoo] Intraoperative controlled hypotension yog tsis pom zoo rau proximal humeral fractures, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob laus, thiab intraoperative ntshav transfusion thiab tranexamic acid yuav siv tau. Intraoperative check of HGB <80g/L pom zoo kom hloov cov ntshav allogeneic (tus kws tshaj lij pom zoo tus nqi: 100%; muaj zog pom zoo tus nqi: 73.8%).
14. Kev tiv thaiv ntawm intraoperative hypothermia
[Cov lus pom zoo] Cov neeg mob uas muaj qhov sib thooj humeral fractures yuav tsum ntxiv dag zog rau kev saib xyuas qhov kub thiab txias thiab siv ntau yam kev ntsuas los tswj cov tub ntxhais kub siab tshaj 36 ° C (tus kws tshaj lij pom zoo tus nqi: 100%; tus nqi pom zoo: 76.2%).
15. Kev xaiv txoj kev phais
(1) Fracture staging ntawm proximal humerus
[Cov Lus Pom Zoo] Neer qhov kev ua yeeb yam raug pom zoo rau qhov sib thooj humerus fracture staging (tus kws tshaj lij pom zoo: 100%; tus nqi pom zoo: 83.3%).
(2) Txoj kev phais
Txoj kev npaj phais yuav tsum raug xaiv raws li pob txha morphology, pob txha zoo, tus neeg mob lub cev thiab lub hlwb thiab lwm yam tseem ceeb.
[Cov Lus Pom Zoo] Cov khoom siv kho mob sab hauv tuaj yeem xaiv tau raws li hom pob txha thiab pob txha ntom ntom, xws li phaj lossis cov ntsia hlau intramedullary; rau cov neeg laus uas muaj pob txha pob txha uas nyuaj rau rov pib dua lossis kho, 4-qho pob txha tawg (thiab pob txha tawg), 3-ntu pob txha tawg nrog pob txha loj, tawg pob txha thiab lub caj dab anatomical pob txha, kev hloov lub xub pwg sib koom ua ke yog xaiv, thiab rov qab lub xub pwg sib koom ua ke yog pom zoo yog ua ke nrog rotator cuff raug mob (10% kev pom zoo tus nqi: 10%).
![Proximal humerus tawg]()
Daim duab 1 Ib tug poj niam muaj hnub nyoog 65 xyoo uas muaj 4-txoj kev tawg ntawm qhov sib thooj humeral adductor insertion thiab ib qho allograft fibular implant phaj fixation nrog incision thiab repositioning.
16. Qhov chaw ntawm lub qhov txhab tso dej
[Cov lus pom zoo] Cov lus qhia rau kev tsis tso cov kav dej: ① Cov txheej txheem kev ua haujlwm tsis zoo (MIPPO thiab intramedullary nailing); ② Los ntshav tsawg. Cov lus qhia rau kev tso cov raj xa dej: ① ntawm pectoral deltoid mus kom ze, Locking plate fixation los yog lub xub pwg ob leeg hloov; ② los ntshav tseem ceeb ntawm qhov txhab qhov txhab (tus kws tshaj lij pom zoo: 100%; tus nqi pom zoo: 71.4%).
17. Lub qhov txhab kaw
【Cov Lus Pom Zoo】 Kev phais phais raug kaw los ntawm kev cuam tshuam yooj yim, txheej los ntawm txheej sutures (tus kws tshaj lij pom zoo tus nqi: 100%; muaj zog pom zoo tus nqi: 76.2%).
18. Kev noj qab haus huv rov qab los
【Cov Lus Pom Zoo】 Cov neeg mob tuaj yeem noj cov dej qab zib tsis pub dhau ntawm lub qhov ncauj thaum lawv tsaug zog tom qab kev phais, thiab rov qab noj zaub mov zoo tom qab 1-2 teev yog tias tsis muaj qhov tshwm sim tsis zoo.
19. Kev xaiv txoj haujlwm tom qab ua haujlwm thiab ua haujlwm thaum ntxov
【Cov Lus Pom Zoo】 Cov neeg mob tsis tas yuav pw ncaj nraim ntawm lub hauv ncoo tom qab kev phais, lawv tuaj yeem txais txoj haujlwm tsis tu ncua thiab tuaj yeem txav mus rau hauv pem teb tom qab sawv. Lub xub pwg nyom brace yuav tsum tau braked.
20. Postoperative analgesic ntsuas
【Postoperative analgesia nyob rau hauv cov neeg mob uas proximal humeral fractures yog pom zoo kom siv lub regional blockade ua ke nrog ib txwm 'tom qab koob' ntawm NSAIDs, thiab yog hais tias tsim nyog, intravenous self-administered analgesia twj los yog peripheral hlab ntsha thaiv tus kheej-tswj tshuaj analgesia tus nqi: 1% kev pom zoo pom zoo: 78.6%).
21. Kev tiv thaiv ntawm xeev siab thiab ntuav tom qab phais
[Cov Lus Pom Zoo] Txhua tus neeg mob yuav tsum tau muab tshuaj prophylactic antiemetic 30 feeb ua ntej qhov kawg ntawm kev phais. (Tus kws tshaj lij pom zoo tus nqi: 97%; tus nqi pom zoo: 47.8%)
22. Kev ua haujlwm zoo dua qub
【Cov Lus Pom Zoo】 Cov neeg mob uas muaj kev ruaj khov thiab ruaj khov ntawm cov pob txha humerus yuav tsum pib ua haujlwm rov ua haujlwm kom sai li sai tau tom qab kev phais. Rehabilitation ce pab kom rov zoo dua qhov kev ua haujlwm ntawm sab sauv qaum (tus kws tshaj lij pom zoo: 100%; Cov lus pom zoo muaj zog: 92.9%).
23. Tshem tawm cov txheej txheem thiab ua raws
【Cov Lus Qhia】 Cov txheej txheem tso tawm yuav tsum tau tsim, thiab cov neeg mob yuav tsum tau ua raws li tsis tu ncua rau tsawg kawg 6 lub hlis (tus kws tshaj lij pom zoo tus nqi: 100%; tus nqi pom zoo: 83.3%).
Yuav Ua Li Cas Orthopedic Implants thiab Orthopedic Instruments?
Rau CZMEDITECH , peb muaj cov khoom tiav heev ntawm kev phais orthopedic implants thiab cov cuab yeej siv, cov khoom suav nrog txha caj qaum implants, intramedullary rau tes, kev raug mob phaj, Locking plate, cranial-maxillofacial cov, prosthesis, cov cuab yeej siv zog, External Fixators, arthroscopy, Veterinary saib xyuas thiab lawv cov cuab yeej txhawb nqa.
Tsis tas li ntawd, peb tau cog lus los txhim kho cov khoom tshiab thiab nthuav dav cov khoom lag luam, kom ua tau raws li kev xav tau ntawm kev phais mob ntawm ntau tus kws kho mob thiab cov neeg mob, thiab tseem ua rau peb lub tuam txhab muaj kev sib tw thoob ntiaj teb Cov khoom cog orthopedic thiab cov cuab yeej kev lag luam.
Peb xa tawm thoob ntiaj teb, yog li koj tuaj yeem ua tau tiv tauj peb ntawm email chaw nyob song@orthopedic-china.com rau ib qho kev tsocai pub dawb, lossis xa lus ntawm WhatsApp rau cov lus teb ceev +86- 18112515727 .
Yog xav paub ntxiv, nyem CZMEDITECH kom paub meej ntxiv.
