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本文收集了法国多个医疗中心的338例器质性低血糖病例,对术前影像诊断和术中定位进行了比较研究。结果发现,315例行术前定位诊断者,成功率为62％。其中超声诊断的成功率23％,C.T.扫描31％,动脉造影53.5％,门脉取血胰岛素放免测定(IRI)70.3％。术前定位成功的195例中,术中能扪及肿瘤者183例(94％),未能扪及的12例中术前动脉造影阳性9例,门脉取血IRI阳性3例。术中定位措施包括扪诊、术中超声、糖和胰岛素反馈系统监测(Biostator)、术中血糖监测和胰岛素监测等。第一次手术证实的243例单个腺瘤中术中能扪
This article collected 338 cases of organic hypoglycemia at multiple medical centers in France and conducted a comparative study of preoperative image diagnosis and intraoperative positioning. The results showed that 315 patients were diagnosed preoperatively with a success rate of 62%. Among them, the success rate of ultrasound diagnosis was 23%, C.T. scan was 31%, arteriography was 53.5%, portal vein blood insulin release assay (IRI) was 70.3%. Of the 195 patients with successful preoperative localization, 183 (94%) had intraoperative energy palpables and tumors. Among the 12 patients who failed to reach preoperative angiography, 9 were positive for preoperative arteriography and 3 were positive for portal venous IRI. Intraoperative positioning measures included palpation, intraoperative ultrasound, glucose and insulin feedback system monitoring (Biostator), intraoperative blood glucose monitoring, and insulin monitoring. The first operation confirmed 243 cases of single adenoma during surgery.