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本文报告胰岛素瘤45例,由于本病少见,容易误诊。文章中对本病的诊断和治疗进行了探讨。Whipple三联征及胰岛素释放指数IRI/G比值>0.3,就有诊断意义。对于少数空腹血糖>2.5mmol/L的病人,可采用饥饿试验、D_(360)胰高糖素等试验,其中饥饿试验简单可靠。在诸多定位诊断方法中,术时仔细检查更为重要,术时B超检查及仔细检查可互相补充,应用得当正确诊断率可提高到90%～100%。PTPCS及动脉造影宜限制应用于再次手术病例。对良性胰岛素瘤力争作肿瘤摘除术,恶性胰岛素瘤由于生物特性较好,应采用积极态度行根治手术。
This article reports 45 cases of insulinoma, because this disease is rare, it is easy to misdiagnose. The article discussed the diagnosis and treatment of this disease. The Whipple triad and the insulin release index IRI/G ratio > 0.3 are diagnostic. For a small number of patients with fasting blood glucose >2.5 mmol/L, starvation tests and D_(360) glucagon tests can be used, among which the hunger test is simple and reliable. In many diagnostic methods, careful examination is more important at the time of surgery. B-ultrasound and careful examination can supplement each other during operation. The correct diagnosis rate can be increased to 90% to 100% when properly applied. PTPCS and arteriography should be limited to reoperation cases. The benign insulinoma strives to be used for tumor resection. Malignant insulinoma should be treated radically because of better biological characteristics.