摘要
目的 探讨胰岛素瘤的诊断治疗经验.方法 对本院2008年3月至2012年12月收治的10例胰岛素瘤资料进行回顾性研究.其中男2例,女8例;年龄11 ～ 52岁,平均（32±15）岁.通过对患者进行定性、定位检查确诊,并进行手术干预和随访观察.结果 7例为单纯性胰岛素瘤,3例为多发性内分泌肿瘤-1型（MEN-1）相关的胰岛素瘤;9例为良性肿瘤,1例为交界性肿瘤.10例均有典型的Whipp1e三联征.肿瘤直径＜2 cm者占79.5％.手术切除肿瘤16个,其中12.5％位于胰头部,6.25％位于胰颈部,25％位于胰体部,56.25％位于胰尾部.术前定位检查发现的胰岛素瘤敏感性：经腹超声检查30.5％,多排螺旋增强CT 68.9％,薄层CT灌注扫描79.5％.术中定位诊断方法的敏感性：术中多普勒超声检查100％.81.25％的病例可行肿瘤的局部摘除术.随访6个月～5年,10例病情稳定,血糖均在正常范围之内.结论 手术切除是胰岛素瘤的最佳治疗方式.薄层CT多期动态增强扫描是目前胰岛素瘤术前定位诊断的首选方法,术中多普勒超声显著提高手术切除率.加强对胰岛素瘤的认识,早期诊断并合理积极的手术治疗,能够改善患者生活质量.
Objective To summarize the experience on diagnosis and treatment of insulinoma. Methods From Mar. 2008 to Jun. 2012, 10 patients of insulinoma were treated in our hospital. Of whom 2 patients were males and 8 females, aged from 11 to 52 years old, mean age （32 ± 15） years. They were definitely diagnosed by laboratory tests, imaging examinations, surgery and follow-up were perfomed on the patients. Results Ten patients were insulinomas, including 1 case of borderline tumor and 9 cases of benign insulinoma. All the 10 patients had typical Whipple＇s triad. The diameters of tumors less than 2 cm were 79.5%. Sixteen tumours were removed by sugery, tumors located in the head of the pancreas were 12.5%, in the neck 6.25%, in the body 25%, and in the tail 56.25%. The positive rates of adjuvant examinations for localization before operation were transabdominal ultrasound 30.5%, enhanced CT 68.9%, thin layer CT perfusion scanning 79.5%. The positive rates of intraoperative ultrasound were 96.5 %. 81.25% patients could be cured by enucleation of tumors. All the patients were followed up from 3 months to 6 years, and 10 patients with good conditions. Coneluslnn Surgical resection is the best treatment for insulinoma. Thin layer CT perfusion scanning is the preferred preoperativeexamination for localiza- tion of insulinoma. Doppler ultrasonic intraoperative can significantly increased the rate of excision. For well recognization and early diagnosis, appropriate surgical intervention will improve patients＇ life quality.
出处
《肝胆胰外科杂志》
CAS
2014年第1期1-4,共4页
Journal of Hepatopancreatobiliary Surgery
关键词
胰腺
胰岛素瘤
诊断
手术治疗
pancreas
insulinoma
diagnosis
surgical treatment
