胰岛素瘤5例诊治体会(1)
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(遂宁市中心医院内分泌科 四川 遂宁 629000)
【摘要】目的:提高对胰岛素瘤的认识、诊断和治疗，同时评价内镜超声(EUS)在胰岛素瘤术前定位诊断中的临床价值。方法:对5例疑为胰岛素瘤的患者的临床资料和定位诊断进行总结分析。术前均行内镜超声、腹部超声以及计算机断层扫描检查，同时与手术中的发现及手术后的病理结果相对比。结果:4例住院期间发生低血糖，3例有典型Whipple三联征，1例饥饿试验诱发。术前 EUS 、CT(平扫+增强) 、US检查，检出率分别为83.3%(5/6)、33.3%(2/6)16.7%(1/6)；，5例全部手术，手术共发现6个病灶，4例为腺瘤，1例为增生。而与手术后病理结果比较，EUS对胰岛素瘤的诊断符效率为80.0%(4/5)，对胰腺病灶的部位以及大小的诊断均基本与手术发现相符。结论:胰岛素瘤常反复发作低血糖，有各种交感神经兴奋及神经精神症状，影像学以 EUS对胰腺占位病灶的术前定位诊断优于传统的影像学检查，且创伤小，是一种临床可行且较有价值的检查方法。
【关键词】低血糖；胰岛素瘤；内镜超声检查
Experience of diagnosis and treatment of insulinoma: an analysis of five cases
Zhu Xiaorong
【Abstract】objectiveTo improve the clinical recognition and diagnosis ability for Insulinoma and investigate the role of endoscopicultrasonography (EUS) in the preoperative localization of insulinoma. Methods Five cases with Insulinoma were reviewed and analyzed retrospectively. The patients underwent abdominal US，CT and EUS in an attempt to precisely localize the tumor before surgery. Surgical and pathological results were considered as the definite localization of tumor and were compared with that of abdominal US, CT and ECDUS. Results Four cases presented hypoglycemia; three cases had typical Whipple’s triad. The positive rate for tumor localization of abdominal US, CT and ECDUS was 16.7%(1/6)、33.3%(2/6)83.3%(5/6) respectively.All the patients were performed operation. Six tumors were detected by surgery and pathology. The sensitivity of EUS in identifying insulinoma was 4/5. Conclusions Patients with Insulinoma usually present fasting hypoglycemia and adrenergic symptoms and central nervous system dysfunction. EUS is a non-invasive and sensitive way to the detect the tumor which is superior to CT or abdominal US ......
(遂宁市中心医院内分泌科 四川 遂宁 629000)
【摘要】目的:提高对胰岛素瘤的认识、诊断和治疗，同时评价内镜超声(EUS)在胰岛素瘤术前定位诊断中的临床价值。方法:对5例疑为胰岛素瘤的患者的临床资料和定位诊断进行总结分析。术前均行内镜超声、腹部超声以及计算机断层扫描检查，同时与手术中的发现及手术后的病理结果相对比。结果:4例住院期间发生低血糖，3例有典型Whipple三联征，1例饥饿试验诱发。术前 EUS 、CT(平扫+增强) 、US检查，检出率分别为83.3%(5/6)、33.3%(2/6)16.7%(1/6)；，5例全部手术，手术共发现6个病灶，4例为腺瘤，1例为增生。而与手术后病理结果比较，EUS对胰岛素瘤的诊断符效率为80.0%(4/5)，对胰腺病灶的部位以及大小的诊断均基本与手术发现相符。结论:胰岛素瘤常反复发作低血糖，有各种交感神经兴奋及神经精神症状，影像学以 EUS对胰腺占位病灶的术前定位诊断优于传统的影像学检查，且创伤小，是一种临床可行且较有价值的检查方法。
【关键词】低血糖；胰岛素瘤；内镜超声检查
Experience of diagnosis and treatment of insulinoma: an analysis of five cases
Zhu Xiaorong
【Abstract】objectiveTo improve the clinical recognition and diagnosis ability for Insulinoma and investigate the role of endoscopicultrasonography (EUS) in the preoperative localization of insulinoma. Methods Five cases with Insulinoma were reviewed and analyzed retrospectively. The patients underwent abdominal US，CT and EUS in an attempt to precisely localize the tumor before surgery. Surgical and pathological results were considered as the definite localization of tumor and were compared with that of abdominal US, CT and ECDUS. Results Four cases presented hypoglycemia; three cases had typical Whipple’s triad. The positive rate for tumor localization of abdominal US, CT and ECDUS was 16.7%(1/6)、33.3%(2/6)83.3%(5/6) respectively.All the patients were performed operation. Six tumors were detected by surgery and pathology. The sensitivity of EUS in identifying insulinoma was 4/5. Conclusions Patients with Insulinoma usually present fasting hypoglycemia and adrenergic symptoms and central nervous system dysfunction. EUS is a non-invasive and sensitive way to the detect the tumor which is superior to CT or abdominal US ......
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