超声内镜引导下无水乙醇注射法与外科手术法治疗良性胰岛素瘤的对比研究

发布时间：2018-04-11 13:04

本文选题：胰岛素瘤 + 超声内镜　；参考：《中国内镜杂志》2017年04期

【摘要】：目的评估超声内镜(EUS)引导下无水乙醇注射法治疗良性胰岛素瘤的疗效与安全性,并与外科手术治疗法相比较。方法回顾性分析2011年4月-2016年2月在广西医科大学第一附属医院经EUS引导下无水乙醇注射法治疗或外科手术法治疗的38例良性胰岛素瘤临床资料。结果 97.4%(37/38)的患者有典型的Whipple三联征,82.9%(29/35)患者低血糖发作时胰岛素释放指数(I/G)0.3。术前B超、CT、磁共振成像(MRI)、正电子发射计算机断层显像(PET/CT)和EUS定位诊断胰岛素瘤阳性率分别为50.0%、67.6%、66.7%、75.0%和89.7%。18例行EUS引导下无水乙醇注射治疗(EUS-FNI组),20例行外科手术治疗(外科手术组),EUS-FNI组术后均无并发症发生,外科手术组中40.0%(8/20)患者出现并发症。与外科手术组相比,EUS-FNI组在手术时间、术中出血、术后并发症、术后住院时间和住院总费用上均明显降低(P0.05)。所有患者均得到随访,EUS-FNI组最后一次无水乙醇注射治疗后所有患者血糖平稳在正常范围;外科手术组20例患者中,90.0%(18/20)患者术后无低血糖症状再发作,监测血糖在正常范围,10.0%(2/20)患者术后低血糖症状发作较术前减少。结论 EUS引导下无水乙醇注射法治疗良性胰岛素瘤安全、有效。与外科手术法相比,具有微创、经济、并发症少和术后恢复快等优势。
[Abstract]:Objective to evaluate the efficacy and safety of EUS-guided anhydrous ethanol injection in the treatment of benign insulinoma.Methods the clinical data of 38 patients with benign insulinoma treated with anhydrous ethanol injection or surgical treatment under EUS guidance in the first affiliated Hospital of Guangxi Medical University from April 2011 to February 2016 were retrospectively analyzed.Results 97.4% of the patients had a typical Whipple triple sign of 82.9% or 29 / 35), and the insulin release index was 0.3% during hypoglycemia.There were no complications in EUS-FNI group.Complications occurred in 40. 0% of 8 / 20 patients in the surgical group.Compared with the surgical group, EUS-FNI group significantly reduced the operation time, intraoperative bleeding, postoperative complications, postoperative hospitalization time and total cost of hospitalization.All patients were followed up in EUS-FNI group after the last anhydrous ethanol injection.The hypoglycemic symptoms in patients with normal blood glucose monitoring were less than those before operation (10.0 / 20 / 20).Conclusion EUS-guided anhydrous ethanol injection is safe and effective in the treatment of benign insulinoma.Compared with surgical procedure, it has the advantages of minimally invasive, economical, less complications and quick postoperative recovery.
【作者单位】：广西医科大学第一附属医院消化内科;广西医科大学第一附属医院内分泌科;广西医科大学第一附属医院胃肠腺体外科;
【基金】：广西壮族自治区卫生和计划生育委员会自筹经费科研项目(No:Z2016322) 国家自然科学基金(No:31360221)
【分类号】：R736.7

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