摘要
目的总结分析胰岛细胞瘤的临床特点,探讨其诊断治疗方法。方法对湖北医药学院附属太和医院10年间收治的31例胰岛细胞瘤患者的临床特点、诊断和治疗方法进行回顾性分析总结。结果 31例患者中,功能性胰岛细胞瘤占26例,无功能性5例;前者的主要表现为各种各样的低血糖症状,均有典型的Whipple三联征;后者主要是腹部包块就诊。血清胰岛素测定对诊断功能性胰岛细胞瘤有重要价值。26例功能性胰岛细胞瘤中CT发现21例(80.8%),而薄层CT扫描的敏感性可达91.7%(11/12)。术中行B超探查有助于术中肿瘤的定位;对于功能性胰岛细胞瘤患者,包括肿瘤在内的胰腺局部切除可取得理想的治疗效果,而切除前后血糖检测对判断肿块切除的完全性有重要价值。而无功能性胰岛细胞瘤往往需要切除较大的范围。结论典型的临床表现、CT薄层扫描、结合胰岛素水平测定是诊断胰岛细胞瘤的有效方法,外科手术切除肿瘤是治疗的有效手段。
Objective To summarize the clinical characteristics and explore the diagnosis and treatment method of the insulinomas.Method The clinical presentations of 31 insulinoma cases admitted to Taihe Hospital affiliated to the Hubei Medical University from 2000 to 2009 summarized retrospectively,and the diagnostic and therapeutical measures analyzed.Results The 26 functioning and 5 nonfunctioning cases were collected.The key clinical symptom of functioning patients was various hypoglycemia but all accompanied typical Whipple triad syndrome,while nonfunctioning tumors was the abdomen mass.The serum insulin could provided the valuable information for the functioning insulinomas.The pre-operation sensitivity of CT for the functioning masses was 80.8%,and the CT scanning with thin slice could improve the sensitivity to 91.7%（11/12）;the intraoperative ultrasonography was a useful measure to located the mass.For the functioning mass,partial pancreatectomy including the mass could gain perfect outcome,and the plasma glucose examined before and after the mass resected could be a effective measure to judge tumours removed completely or not;while distal splenopancreatectomy,distal pancreatectomy or pancreatoduodenal resection often needed for the nonfunctioning insulinomas.Conclusion The typical clinical presentation,thin slice CT scanning and The serum insulin level were the effective measures for the diagnosis for the insulinoma,while the intraoperative ultrasonography was a useful localization measure for the mass resected,and surgery was the treatment of choice and the only curative option for the insulinoma patients.
出处
《肝胆外科杂志》
2011年第3期213-215,共3页
Journal of Hepatobiliary Surgery
