摘要
目的探讨内镜超声引导下无水乙醇注射治疗良性胰岛素瘤的安全性及有效性。方法采用前瞻性设计观察自2013年12月至2015年1月广西医科大学第一附属医院收治的10例通过内镜超声引导下细针穿刺病理活检确诊为良性胰岛素瘤患者的研究结果。结果在内镜超声引导下通过细针穿刺病灶处注射0．10～2，00ml（0．70±0．62ml）无水乙醇共进行15次治疗，术中、术后均未出现并发症，术后血糖水平较术前升高[4．8（3．9—5．5）mmol／L比2．4（1．9～2．5）mmol,／L，P〈0．05]；胰岛素水平显著降低[83．7（40．1—143．5）pmol／L比177．3（66．5～200．6）pmol／L，P〈0．05]。术后平均住院日为（4．3±1．5）d。术后随访（6个月～1年）内镜超声可见病灶随时间推移回声较前明显减低，而超声造影呈低增强、乏血供改变。结论内镜超声引导下无水乙醇注射治疗良性胰岛素瘤安全、有效，有可能是一种新的微创治疗方法。临床试验注册美国临床试验中心。
Objective To evaluate the safety and efficacy of endoscopic ultrasonography （EUS） guided ethanol ablation in patients with insulinoma. Methods The data of 10 patients with insulinoma trea- ted at the First Affiliated Hospital of Guangxi Medical University from December 2013 to January 2015 were prospectively analyzed. Results The patients were given EUS-guided ethanol ablation with dose of 0. 10 to 2. 00 ml （average 0. 70 ± 0. 62 ml） in pancreatic lesions for 15 times. No complications were observed during and after the procedure. The blood glucose improved after the procedure [4. 8（3.9-5. 5） mmo//L VS 2. 4 （ 1.9-2. 5） mmol/L, P 〈 0. 05 ] and the serum insulin level significantly decreased [ 83.7 （ 40. 1-143.5 ） pmol/L VS 177.3（66. 5-200. 6） pmol/L,P〈0. 05]. The average hospital stay was （4. 3＋1.5） days. The patients were followed up for 6-12 months. EUS indicated that the echo of pancreatic lesions changed from high to low. CE-EUS revealed low enhancement and lack of blood supply. Conclusion EUS-guided ethanol ablation may become a promising minimally invasive treatment for insulinoma because of its safety, efficacy and low price. Trail registration Clinical Trial.gov, NCT02121366
出处
《中华消化内镜杂志》
北大核心
2016年第2期72-76,共5页
Chinese Journal of Digestive Endoscopy
基金
广西高等学校科研项目（桂教科研：LX2014076）
