CAJ | 학술논문

目的探讨胰岛素瘤诊断和治疗的方法.方法回顾性分析安徽医科大学附属省立医院1998年1月-2011年1月收治28例胰岛素瘤患者的临床资料.结果 24例功能性胰岛素瘤患者均有典型Whipple三联征表现;无功能性胰岛细胞瘤4例.术前超声、CT和术中超声定位诊断阳性率分别为60.9％(14/23)、84.6％ (22/26)和90％(9/10).行单纯肿瘤摘除术17例,胰体尾切除术3例,胰体尾联合脾切除术8例.病理诊断均为胰岛素瘤,术后无低血糖症发作,术后5例患者发生胰瘘.结论多排螺旋CT薄层扫描是目前胰岛素瘤术前定位诊断的首选方法.术中B超是对术前胰岛素瘤定位的检验和补充,有利于胰岛素瘤的定位;术中血糖的检测是判断胰岛素瘤切除效果的重要指标.绝大多数胰岛素瘤可经手术摘除治愈.
목적 탐토이도소류진단화치료적방법.방법 회고성분석안휘의과대학부속성립의원1998년1월-2011년1월수치28례이도소류환자적림상자료.결과 24례공능성이도소류환자균유전형Whipple삼련정표현;무공능성이도세포류4례.술전초성、CT화술중초성정위진단양성솔분별위60.9％(14/23)、84.6％ (22/26)화90％(9/10).행단순종류적제술17례,이체미절제술3례,이체미연합비절제술8례.병리진단균위이도소류,술후무저혈당증발작,술후5례환자발생이루.결론 다배라선CT박층소묘시목전이도소류술전정위진단적수선방법.술중B초시대술전이도소류정위적검험화보충,유리우이도소류적정위;술중혈당적검측시판단이도소류절제효과적중요지표.절대다수이도소류가경수술적제치유.
Objective To explore the diagnosis and management of insulinoma.Methods Retrospectively analyzed 28 cases of insulinoma treated in Affiliated Provincial Hospital of Anhui Medical University from Jan 1998 to Jan 2011.Results Twenty-four cases of functional insulinoma had typical Whipple' s triad.Four cases were nonfunctional insulinoma.The diagnostic sensitivity of preoperative BUS,CT and intraoperative BUS was respectively 60.9％ (14/23),84.6％ (22/26) and 90％ (9/10).Simple tumor enucleation was performed in 17 cases,distal pancreatic resection was performed in 3 cases,resection of distal pancreas plus the spleen was performed in 8 cases.The final pathologically of insulinoma was presented in all of the 28 cases.Hypoglycemia disappeared after resection in all cases.Pancreatic fistula occurred in five patients.Conclusions Multi-slice spiral CT came to be the preferred preoperative examination for location of insulinoma.Intraoperative BUS is the supplement to preoperative location diagnosis.Intraoperative blood sugar test is main index to judge the effect of insulinoma resection.Most insulinomas can be cured by surgical resection.