中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2012年
10期
771-774
,共4页
张金山%李龙%刘树立%侯文英%马丽霜%叶辉%刁美%明安晓%王海滨%李胜利%刘垚
張金山%李龍%劉樹立%侯文英%馬麗霜%葉輝%刁美%明安曉%王海濱%李勝利%劉垚
장금산%리룡%류수립%후문영%마려상%협휘%조미%명안효%왕해빈%리성리%류요
腹腔镜%婴儿持续性高胰岛素血症低血糖症%治疗结果
腹腔鏡%嬰兒持續性高胰島素血癥低血糖癥%治療結果
복강경%영인지속성고이도소혈증저혈당증%치료결과
Laparoscopes%Persistent hyperinsulinemic hypoglycemia of infancy%Treatment outcome
目的 通过研究腹腔镜胰腺部分切除术治疗婴儿持续性高胰岛素血症性低血糖( persistent hyperinsulinemic hypoglycemia of infancy,PHHI)的技术和效果,探讨该技术的可行性和有效性.方法 分析2008年9月至2011年4月4例PHHI患儿接受腹腔镜胰腺部分切除术治疗的临床资料.术后对所有患儿进行跟踪随访,内容包括术后低血糖症状缓解与否,定期复查血胰岛素、血糖浓度等.结果 手术时间170～190 min,术中出血量较少,无输血者.术后腹腔引流时间为2～7 d,术后住院时间为12～24 d.术后空腹血糖浓度较术前升高(术前:0.4～8.0 mmol/L,平均2.8 mmol/L；术后:2.6～15.2 mmol/L,平均7.5 mmol/L),术后空腹血胰岛素浓度较术前降低(术前:52.9～102.3 mU/L,平均77.4 mU/L；术后:3.7～13.3 mU/L,平均7.2 mU/L).迄今随访2～32个月,此间行胰腺大部切除的3例血糖浓度和血胰岛素浓度恢复正常,未出现复发.行腹腔镜局灶性病变切除1例术后7个月,因低血糖症状复发,手术探查发现胰头结节,再次行胰腺结节切除术,术后至今已25个月,恢复良好,未出现低血糖症状.结论 腹腔镜胰腺部分切除术治疗PHHI是安全、有效的.
目的 通過研究腹腔鏡胰腺部分切除術治療嬰兒持續性高胰島素血癥性低血糖( persistent hyperinsulinemic hypoglycemia of infancy,PHHI)的技術和效果,探討該技術的可行性和有效性.方法 分析2008年9月至2011年4月4例PHHI患兒接受腹腔鏡胰腺部分切除術治療的臨床資料.術後對所有患兒進行跟蹤隨訪,內容包括術後低血糖癥狀緩解與否,定期複查血胰島素、血糖濃度等.結果 手術時間170～190 min,術中齣血量較少,無輸血者.術後腹腔引流時間為2～7 d,術後住院時間為12～24 d.術後空腹血糖濃度較術前升高(術前:0.4～8.0 mmol/L,平均2.8 mmol/L；術後:2.6～15.2 mmol/L,平均7.5 mmol/L),術後空腹血胰島素濃度較術前降低(術前:52.9～102.3 mU/L,平均77.4 mU/L；術後:3.7～13.3 mU/L,平均7.2 mU/L).迄今隨訪2～32箇月,此間行胰腺大部切除的3例血糖濃度和血胰島素濃度恢複正常,未齣現複髮.行腹腔鏡跼竈性病變切除1例術後7箇月,因低血糖癥狀複髮,手術探查髮現胰頭結節,再次行胰腺結節切除術,術後至今已25箇月,恢複良好,未齣現低血糖癥狀.結論 腹腔鏡胰腺部分切除術治療PHHI是安全、有效的.
목적 통과연구복강경이선부분절제술치료영인지속성고이도소혈증성저혈당( persistent hyperinsulinemic hypoglycemia of infancy,PHHI)적기술화효과,탐토해기술적가행성화유효성.방법 분석2008년9월지2011년4월4례PHHI환인접수복강경이선부분절제술치료적림상자료.술후대소유환인진행근종수방,내용포괄술후저혈당증상완해여부,정기복사혈이도소、혈당농도등.결과 수술시간170～190 min,술중출혈량교소,무수혈자.술후복강인류시간위2～7 d,술후주원시간위12～24 d.술후공복혈당농도교술전승고(술전:0.4～8.0 mmol/L,평균2.8 mmol/L；술후:2.6～15.2 mmol/L,평균7.5 mmol/L),술후공복혈이도소농도교술전강저(술전:52.9～102.3 mU/L,평균77.4 mU/L；술후:3.7～13.3 mU/L,평균7.2 mU/L).흘금수방2～32개월,차간행이선대부절제적3례혈당농도화혈이도소농도회복정상,미출현복발.행복강경국조성병변절제1례술후7개월,인저혈당증상복발,수술탐사발현이두결절,재차행이선결절절제술,술후지금이25개월,회복량호,미출현저혈당증상.결론 복강경이선부분절제술치료PHHI시안전、유효적.
Objective To study the safety and efficacy of laparoscopic partial pancreatectomy for the treatment of persistent hyperinsulinemic hypoglycemia of infancy (PHHI).Methods Between September 2008 and April 2011,the laparoscopic partial pancreatectomy was performed on 4 infants with PHHI.The levels of blood sugar and insulin were followed-up and retrospectively analyzed in this study.Results The operating time ranged from 170 to 190 min,and blood loss during surgery was minimal without necessity for blood transfusion.The length of hospital stay after operation was 12 to 24 days.The duration of postoperative abdominal drainage was 2 to 7 days.The level of fasting blood glucose after surgery was higher than that before surgery (7.5mmol/L vs.2.8mmol/L),The level of fasting insulin after surgery was lower than that before surgery (7.2 mU/L vs.77.4 mU/L),The patients were followed up for 2 to 32 months.The 3 patients underwent 90％ pancreatectomy had normal blood glucose and insulin.The patient underwent focal resection was performed secondary pancreatectomy due to recurrence of hypoglycemia,and had normal blood glucose and insulin after operation.Conclusions Laparoscopic partial pancreatectomy is safe and effective for the treatment of PHHI in children.
