论文部分内容阅读
目的 总结小儿少见的胰岛细胞增生症的诊断和外科治疗要点。方法 收集本院 10年内收治的 4例患儿资料 ,从症状、血糖、胰岛素及其比值、手术方法、术后监测等方面进行分析。结果 1例首次手术切除胰腺量不够 ,术后复发 ,3年后再次手术治愈 ,但遗留脑损害 ;1例术后败血症死亡 ;2例切除胰腺 95 %以上 ,术后血糖胰岛素恢复正常。结论 ①新生儿及婴幼儿期反复出现抽搐、低血糖症状要考虑由于胰岛细胞增生所致的高胰岛素血症 ,需作血糖胰岛素比值测定及B超、CT检查排除胰腺占位性病变 ;②一旦诊断明确尽早手术 ,减轻脑损害。尤其是新生儿期发病者 ,应在诊断明确后尽早手术 ,术后症状复发者亦应果断再次手术 ;③正确进行胰腺大部分切除术 ,切除胰腺组织不能少于 95 %。
Objective To summarize the diagnosis and surgical treatment of infantile islet cell hyperplasia. Methods The data of 4 cases admitted to our hospital within 10 years were collected and analyzed from the aspects of symptoms, blood glucose, insulin and its ratio, surgical methods and postoperative monitoring. Results One case had insufficient resection of the pancreas and relapsed after operation. The operation was cured again 3 years later, but left brain damage. One patient died of postoperative sepsis. Two patients underwent more than 95% resection of the pancreas and the postoperative blood glucose and insulin returned to normal. Conclusions ①There are recurrent seizures in neonates and infants. Symptoms of hypoglycemia should be considered for hyperinsulinemia due to islet cell hyperplasia. Blood glucose and insulin ratio and B-ultrasound and CT examination should be used to exclude pancreatic space-occupying lesions. Diagnosis as soon as possible surgery to reduce brain damage. In particular, the incidence of neonatal period, should be diagnosed as soon as possible after surgery, postoperative recurrence of symptoms should also be reoperation; ③ most of the correct resection of the pancreas, resection of the pancreas can not be less than 95%.