论文部分内容阅读
患者男,43岁。于1971年出现以低血糖为主的一系列症状,经多家医院诊治曾诊为脑肿瘤,血管神经性头痛,血吸虫性脑病。1976年去上海进一步检查才明确诊断为胰岛细胞瘤。行胰腺部分切除,脾切除,周围淋巴结清扫术。病理报告:胰岛细胞瘤(恶性),周围淋巴结转移。术后用5—FU化疗一个疗程,出院继续化疗3个月,同时注肿节风针每日2支,120支为一个疗程。术后低血糖症状缓解,恢复上班,间断口服5-Fu。术后11年间,多次B超检查:胰腺未发现占位。1987年重新出现低血糖症状,发现肝脏28×30mm块影。当时认为血吸虫病所致。2年后,B超追踪复查:肝脏分别发现28×30mm,27×20mm,10×11mm三个块影。1990年因低血糖症状加重,考虑肝转移去上海复查,同年6月14日行剖腹探查术,证实转移性肝癌难以手术切除,在监护室行肝动脉插管,用美国进口ADM 50mg。7月 6日出院后,低血糖症状明显缓解,继续5-Fu口服,在化疗期间症状缓解,停药期间症状
The patient was 43 years old. In 1971, a series of symptoms, mainly hypoglycemia, were diagnosed and treated by a number of hospitals as brain tumors, neurovascular headaches, and schistosomal encephalopathy. In 1976, she went to Shanghai for further examination to confirm the diagnosis of islet cell tumor. Partial pancreatic resection, splenectomy, peripheral lymph node dissection. Pathology report: Islet cell tumor (malignant), peripheral lymph node metastasis. After 5-FU chemotherapy for a course of treatment, the patient was discharged for 3 months. At the same time, two injections of swollen wind needles were administered daily, 120 for one course of treatment. Hypoglycemic symptoms relieved after surgery, resumed work, intermittent oral 5-Fu. During the 11-year period after surgery, multiple B-ultrasound examinations revealed that no placeholders were found in the pancreas. Hypoglycemia recurred in 1987 and a 28 x 30 mm liver shadow was found. At that time, it was thought to be caused by schistosomiasis. Two years later, follow-up review of B ultrasound: Liver were found in 28×30mm, 27×20mm, and 10×11mm three blocks. In 1990, due to the worsening of hypoglycemia, consider liver metastases to Shanghai for review, and on June 14 of the same year, laparotomy was performed. It was confirmed that metastatic liver cancer was difficult to remove by surgery. Hepatic artery catheterization was performed in the intensive care unit and ADM 50 mg was imported from the United States. After July 6th hospitalization, hypoglycemia was relieved obviously and 5-Fu was continued. Symptoms were relieved during chemotherapy and the symptoms were discontinued.