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目的探讨胰腺血管活性肠肽瘤(VIPoma)的临床、实验室和影像学特点,以及诊断方法和治疗手段。方法报道1例胰腺VIPoma,同时检索国内文献得到49例胰腺VIPoma患者临床资料,并对此50例病例进行分析。结果分泌性腹泻、低血钾和代谢性酸中毒是胰腺VIPoma的主要临床表现,血浆血管活性肠肽(VIP)水平增高具有诊断价值。经手术治疗,腹泻症状可减轻或消失;对于远处转移患者,生长抑素、化疗、干扰素等治疗均有效。结论 VIPoma早期诊断困难,确诊依赖于典型临床症状、血浆VIP水平、影像学检查以及免疫组化检查。手术切除可改善预后,生长抑素等治疗可缓解症状,发生转移者也应积极治疗。
Objective To investigate the clinical, laboratory and imaging characteristics of pancreatic vasoactive intestinal peptide peptide (VIPoma), as well as diagnostic methods and treatment methods. Methods A case of pancreas VIPoma was reported. At the same time, 49 cases of pancreatic VIPoma were retrieved from domestic literatures, and 50 cases were analyzed. Results Secretive diarrhea, hypokalemia and metabolic acidosis were the main clinical manifestations of VIPoma in the pancreas. The increased level of plasma vasoactive intestinal peptide (VIP) was of diagnostic value. After surgery, diarrhea symptoms can be reduced or disappeared; for patients with distant metastasis, somatostatin, chemotherapy, interferon and other treatments are effective. Conclusions VIPoma is difficult to diagnose early. Diagnosis depends on typical clinical symptoms, plasma VIP level, imaging examination and immunohistochemistry. Surgical resection can improve the prognosis, somatostatin treatment can relieve the symptoms, the transfer of persons should also be actively treated.