CAJ | 학술논문

目的总结胰岛素瘤的诊断和治疗经验.方法回顾性分析1966年1月-2007年12月收治的131例胰岛素瘤患者的临床资料. 结果全组病例均有Whipple三联征表现;64例有不同的精神症状表现.空腹或发作时血糖均<2.8 mmol/L;胰岛素释放指数检测88例,均>0.3;术前B超75例,检出肿瘤8例;腹部CT68例,检出17例;腹部MRI 10例,检出5例;术中B超44例,明确肿瘤定位43例.手术方式:肿瘤摘除术88例,胰体尾切除40例,胰十二指肠切除2例,活检1例.130例术后血糖渐恢复正常,术后胰瘘20例,急性胰腺炎32例;常规应用术中B超后无胰瘘和胰腺炎发生.结论根据Whipple三联征、胰岛素释放指数等明确胰岛素瘤定性诊断不难;手术探查联合术中B超是有效的定位诊断方法.
목적 총결이도소류적진단화치료경험.방법 회고성분석1966년1월-2007년12월수치적131례이도소류환자적림상자료. 결과전조병례균유Whipple삼련정표현;64례유불동적정신증상표현.공복혹발작시혈당균<2.8 mmol/L;이도소석방지수검측88례,균>0.3;술전B초75례,검출종류8례;복부CT68례,검출17례;복부MRI 10례,검출5례;술중B초44례,명학종류정위43례.수술방식:종류적제술88례,이체미절제40례,이십이지장절제2례,활검1례.130례술후혈당점회복정상,술후이루20례,급성이선염32례;상규응용술중B초후무이루화이선염발생.결론 근거Whipple삼련정、이도소석방지수등명학이도소류정성진단불난;수술탐사연합술중B초시유효적정위진단방법.
Objective To summarize the experience in the diagnosis and management of insulinoma. Methods From January 1966 to December 2007, the clinical data of 131 patients with insulinoma were retrospectively analyzed. Results All the 131 cases had Whipple triad syndrome and 64 eases suffered from psychoneurosis symptoms. The fasting blood glucose or insultus blood glucose concentration of all the cases was lower than 2.8 mmol/L. The ratios of serum insulin to glucose were all higher than 0.3. Before operation, tumor was detected in 8 of 75 patients by B-us scan, and in 17 of 68 by CT, and in 5 of 10 by MRI. The intraoperative ultrasonography(IOUS) was applied in 44 eases, and tumor was found in 43 cases. Surgery included enucleation of insulinoma (88 cases), resection of the corpus and eauda of the pancreas (40 cases), duodenopancreatectomy (2 cases), and biopsy (1 case). The low blood glucose symptoms disappeared postoperatively in 130 cases. Pancreatic fistulae occurred in 20 cases, acute pancreatitis occurred in 32 cases. Conclusions Insulinoma can be diagnosed based on symptoms of Whipple triad and the ratio of serum insulin to glucose. Exploration and IOUS are the simple and effective methods to localize insulinoma.