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目的 探讨胰岛细胞瘤的诊断和治疗方法。方法 回顾性分析56例胰岛细胞瘤患者的临床资料。结果 术前B超、CT、MR、数字减影血管造影术和术中B超诊断准确率分别为40. 38%、43. 24%、60. 87%、77. 78%和95. 24%。56例患者均行手术探查,单纯摘除肿瘤或其周围部分胰腺组织切除38例,胰体尾部切除+脾切除9例,胰十二指肠切除5例,胰腺部分切除+胰空肠吻合2例,探查活检2例。结论 术中探查和B超是目前定位最好的方法,术中监测血糖变化是一简便预测手术成功率的方法,对探查和肿瘤切除的彻底性有指导意义。
Objective To investigate the diagnosis and treatment of islet cell tumor. Methods The clinical data of 56 patients with islet cell tumor were retrospectively analyzed. Results The accuracy of preoperative B-ultrasound, CT, MR, digital subtraction angiography and intraoperative ultrasonography were 40. 38%, 43.24%, 60.87%, 77.78% and 95.24% . Fifty-six patients underwent surgical exploration. Thirty-eight cases underwent resection of the tumor or the surrounding pancreas, 9 cases of pancreatic body tail excision and splenectomy, 5 cases of pancreatoduodenectomy, 2 cases of pancreatic partial resection plus pancreaticojejunostomy, Biopsy in 2 cases. Conclusions Intraoperative exploration and B-ultrasound are the best methods for the current localization. Monitoring intra-operative blood glucose changes is a simple and convenient method to predict the success rate of surgery, which is instructive for the thoroughness of exploration and tumor resection.