功能性胰岛素瘤21例诊治体会  

Diagnosis and management of 21 cases with functional insulinoma

作　　者：施巍巍[1] 张挺[1] 沈波[1] 施超[1] 

机构地区：[1]启东市人民医院普通外科,226200

出　　处：《江苏医药》2009年第2期154-155,共2页Jiangsu Medical Journal

摘　　要：目的总结功能性胰岛素瘤诊治体会。方法回顾性分析胰岛素瘤21例:14例有典型的Whipple三联症;病程中曾误诊为癔病5例,癫痫3例,精神分裂症及脑血栓各2例,脑出血及散发性脑炎各1例,误诊率达66.4%(14/21)。空腹血糖或发作期血糖平均为2.1 mmol/L,空腹血胰岛素平均为31.6 mU/L。B超及CT检查阳性率分别为38.1%(8/21)和40.0%(8/20)。结果术中探查扪诊正确率为100%。17例行单纯胰岛素瘤摘除术,2例行胰体尾切除术,2例胰颈部肿瘤摘除及胰体尾空肠Roux-en-Y吻合术。肿瘤切除后血糖即显著升高,5、15、30、60、120 min和24、48、72 h血糖均值分别为5.8、7.6、8.3、9.6、13.3和13.4、11.7、9.2 mmol/L。结论功能性胰岛素瘤临床少见,容易被误诊。定位诊断以术中的细致触诊最为重要;术中活检和动态血糖监测可避免手术失误。Objective To summerize the experience of treating functional insulinoma.MethodsThe data from 21 cases with functional insulinoma were retrospectively analyzed,of which 14 cases had typical Whipple′s trial signs.Misdiagnosed as hysteria in 5 cases,as epilepsy in 3 cases,as schizophrenia in 2 cases,as cerebral thrombosis in 2 cases,as cerebral tasculitis in 1 case and as unepidemic encephalitis in 1 case.The misdiagnosis rate reached to 66.4%(14/21).The level of average fast blood sugar(FBS) or blood glucose(...

关 键 词：胰岛素瘤 

分 类 号：R736.7[医药卫生—肿瘤]