【Abstract】 Objective To evaluate the effects of allogeneic bone graft for reconstructing bone defect of clavicle aftertumor resection. Methods Nine patients received the surgical procedures for repairing and reconstructing bone defect afterresection of clavicle tumor from January 2000 to January 2006. There were 4 males and 5 females aged 12 to 68 years. Two patientswere diagnosed as having benign tumor and tumor-like lesion(stage Ⅲ according to Campanacci grading), and 7 as having primarymalignant tumor and metastatic cancer. Three lesions were located in acromial end, 2 in sternal end and 4 in shaft of clavicle. Twocases was accompanied by pathological fracture. According to Enneking’s functional evalutation, the results were excellent in 3 cases,good in 3 cases, fair in 1 case and poor in 2 cases. Based on the visual analogue scale (VAS), pain was rated as medium rest-pain in4 cases, as medium move-pain in 3 cases and heavy pain in 2 cases preoperatively. The tumor was resected with en bloc. Defectedclavicles were reconstructed by a part of allograft clavicle and plate. The patients with malignant tumor received neo-adjuvant chemotherapyand radiotherapy postoperatively. The results were evaluated according to control of tumor, rel ief of pain, bone healingand shoulder joint function. Results These patients were followed up 12 to 70 months (mean 34.6 months). There were no localrecurrence and metastases in all patients during the follow-up. No complications of immune rejection and deep infection wereseen. The normal shape of the shoulders was restored. Eight of all patients showed primary bone healing between allograft boneand host bone. The mean healing time was 5.4 months (3.2-6.8 months). Loosening of the plate and nonunion were seen in 1 case;and bone grafting was given again. Fracture of allograft occurred in 1 case after removing internal fixation. According to Enneking’s functional evulation, the results were excellent in 6 cases and good in 3 cases at 3 months after operation; excellent in 4 cases, goodin 1 case and fair in 1 case among 6 patients who were followed up for 24 months. The VAS results of postoperation showed l ightmove-pain in 2 cases at 3 months, l ight move-pain and medium move-pain in 1 case respectively and no pain in 7 cases 12 months after operation. Conclusion Allogeneic clavicle is a useful and rel iable reconstructive material for clavicle defect due to tumor resection. The satisfactory shape and favorable function of the shoulder may be recovered after this procedure.
目的探讨胰周动脉瘤破裂出血的诊治。方法回顾3例胰周动脉瘤破裂出血患者的诊治过程，并结合相关文献进行分析。 结果3例患者胰周动脉瘤破裂出血并失血性休克，其中1例术前经CT检查获得诊断，2例术前未能诊断。2例经手术止血治愈，分别随访1年和1年2个月，未见复发及相关并发症; 1例经抢救无效死亡。结论胰周动脉瘤破裂出血病情发展迅速，术前诊断困难，尽快液体复苏及积极手术探查止血是挽救生命的关键。