摘要
胰岛素瘤是胰腺β细胞来源的肿瘤,约占功能性胰岛细胞瘤的60%～80%,年发病率在（1～4）/100万.胰岛素瘤的临床及流行病学特点导致多数患者在初次就诊时不能正确诊断,从发病到确诊时间平均为33个月,相当一部分患者被误诊为癫痫或者脑血管病接受长期治疗.
Insulinoma is derived from beta cells, and the yearly incidence of insulinoma is 1-4 per one million. Insulinoma patients were often misdiagnosed with epilepsy or cerebrovascular diseases because of the clinical and epidemiological features of insulinoma. The diagnosis of the insulinoma is usually made biochemically with the presence of low blood glucose （ 〈2.5 mmol/L）, elevated insulin （ ≥6 mU/L） and C-peptide levels （ ≥ 200 pmol/L）, and no sulfonylureas in the blood.Supervised 72-hour fasting test has been verified as the gold standard in establishing a biochemical diagnosis of insulinoma.Localization of insulinoma is useful for selecting surgical procedures, and the methods for localization can be divided into noninvasive （transabdominal ultrasound, computed tomography,magnetic resonance imaging and endoscopic ultrasound）, invasive （angiography and arterial stimulation venous sampling） and intraoperative diagnosis. Surgical treatment is the only curative method at present, and the common approaches include enuclea tion, partial pancreatic resection, resection of the body and tail of pancreas and duodenum-preserving pancreatic head resection.Most patients with sporadic insulinoma had long-term survival after the surgery. For insulinoma patients with multiple endocrine neoplasia type 1, an aggressive surgical approach is recommended.
出处
《中华消化外科杂志》
CAS
CSCD
2010年第5期326-328,共3页
Chinese Journal of Digestive Surgery
