胰岛素瘤9例诊治报告

Diagnosis and Treatment of Insulinoma (A Report of 9 Cases)

目的 为提高胰岛素瘤的早期诊断 ,防止误诊误治。 方法 回顾性分析 9例胰岛素瘤的诊治经过。 结果 虽本组均有Whipple三联症 ,但临床误诊率高。误诊的主要原因是①本病少见 ,对其警惕性不高 ;②不同病人 ,甚至同一病 ,每次发作可有不同表现。 结论 对临床表现为交感神经兴奋、意识障碍、癫痫样症状、精神症状等应考虑胰岛素瘤所致低血糖 ,应针对性检查血糖和胰岛素瘤测定 ,如明确诊断即应手术治疗。术中找不到肿瘤 ,应再观察 1～ 2年二次手术探查。

Objective[WT5”BZ] To increase the early diagnosis rate of insulinoma and to avoid misdiagnosis and maltreatment. [WT5”HZ]Methods [WT5”BZ]Nine insulinoma cases were retrospectively analysed for their diagnosis and therapy. [WT5”HZ]Results[WT5”BZ] Though Wipple was their major presentation,the rate of clinical misdiagnosis of insulinoma remained high because of little alertness on this rare disease and different presentations in patients.[WT5”HZ] Conclusion [WT5”BZ]Such clinical presentations as sympathetic hyperfunction,disorder of consciousness,epileptic state and mental symptoms should be taken into account for hypoglycosemia caused by insulinoma.More clinical examminations should be taken,such as blood insuline and glucose exam.Operation should be adopted as soon as the diagnosis of insulinoma is recognized.A second operative look after one or two years of the first operation is a good choice if we cannot find insulinoma.