CAJ | 학술논문

目的探讨功能性胰岛素瘤的诊治特点,提高对该病的认识.方法回顾性分析2000年至2009年吉林大学中日联谊医院收治的12例功能性胰岛素瘤临床资料.结果 12例术前空腹血糖值和胰岛素阳性率分别为92%和89%,IRI/G和C-肽的阳性率达100%.术前腹部超声、CT和MRI定位诊断准确率分别是75%、36%和0%,而术中扪诊结合术中超声的定位准确率达100%.术中血糖监测,10例在肿瘤切除后1 h内血糖上升1倍以上,2例1.5 h后上升1倍以上.随访7例,均未再出现低血糖症状.3例胰瘘.结论对疑有功能性胰岛素瘤的病例,除检测血糖、胰岛素外还应检测IRI/G、C-肽.术中扪诊及超声是肿瘤定位的有效手段.监测肿瘤切除后血糖变化,结合术中快速病理可判定肿瘤是否完全切除.
목적 탐토공능성이도소류적진치특점,제고대해병적인식.방법 회고성분석2000년지2009년길림대학중일련의의원수치적12례공능성이도소류림상자료.결과 12례술전공복혈당치화이도소양성솔분별위92%화89%,IRI/G화C-태적양성솔체100%.술전복부초성、CT화MRI정위진단준학솔분별시75%、36%화0%,이술중문진결합술중초성적정위준학솔체100%.술중혈당감측,10례재종류절제후1 h내혈당상승1배이상,2례1.5 h후상승1배이상.수방7례,균미재출현저혈당증상.3례이루.결론 대의유공능성이도소류적병례,제검측혈당、이도소외환응검측IRI/G、C-태.술중문진급초성시종류정위적유효수단.감측종류절제후혈당변화,결합술중쾌속병리가판정종류시부완전절제.
Objective To improve the knowledge of the diagnosis and treatment of functional insulinoma. Methods The clinical data of 12 cases of functional insulinoma in China-Japan Union Hospital of Jilin University from 2000 to 2009 were analyzed retrospectively. Results For the 12 cases of functional insulinoma, preoperative fasting blood glucose and the positive rate of insulin were 92% and 89% respectively. The positive rate of IRI/G and C-Peptide reached 100%. The accuracy of the niveau diagnosis of preoperative abdomen ultrasound, CT and of MRI were 75%, 36% and 0% respectively; whereas the accuracy of localization of intraoperative palpation combined with ultrasonography reached 100%. The result of glucose increased by one time within one hour after excision and the rest excision. In the 7 follow-up cases, the symptom of hypoglycemia was not found. There were 3 cases of pancreatic fistula after operation. Conclusions For the suspected cases of functional insulinoma, the measurement of IRI/G and C-Peptide are needed besides measuring blood glucose and insulin. Intraoperative palpation and ultrasonography are effective methods of the localization of functional insulinoma. The complete resection of the insulinoma can be assessed by monitoring the change of the blood glucose after excision as well as the rapid intraoperative pathological examination.