20例胰岛素瘤的临床分析

Clinical analysis of 20 cases of insulinoma

目的 :总结胰岛素瘤的诊治经验以减少误诊率。方法 :回顾性分析经手术治疗的 2 0例胰岛素瘤的临床资料。结果 :病人均曾被误诊 ,平均误诊时间 4 .1年。手术治愈 17例 (85 % )。结论 :典型的Whipple三联征 ,辅以葡萄糖耐量试验同时测定IRI G比值是定性诊断的基本方法 ,术中扪诊联合术中B超是准确定位的关键 ,肿瘤摘除术仍为胰岛素瘤的主要术式。

Objective To summarize the experience in the diagnosis and treatment of insulinoma so as to decrease the misdiagnositic rate. Methods The clinical data of 20 patients with insulinoma were reviewed. Results The patients were all misdiagnosed before admission to hospital and the average interval from the onset of symptoms to the diagnosis was 4.1 years. Seventeen (85%) patients were cured by surgical treatment. Conclusion Whipple's triad, the oral glucose tolerance Test (OGTT) and the ratio of immunoreactive insulin to blood glucose are the bases for qualitative diagnosis of insulinoma. Meticulously palpating the gland combined with ultrasound imaging in the operation is the key to accurate localization. The simple enucleation is the main mode of surgical treatment of insulinoma.