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摘要: 一例老年男性患者因胰尾部胰岛素瘤反复发作导致低血糖，频繁发作意识障碍，因传统影像学的局限性难以具体定位肿瘤位置，且患者高龄伴慢性肾脏病，外科手术治疗风险较高。经多学科团队讨论后，采用前沿的影像学检查方法和新兴的内镜治疗技术，最终解决了患者的诊治难题。在该例患者诊治过程中，多学科团队应用本领域最新技术共同诊治，体现了多学科协作的重要性。
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关键词:
- 胰岛素瘤 /
- 超声内镜 /
- 正电子发射计算机断层显像
Abstract: This patient had recurrent hypoglycemia and frequent disturbance of consciousness caused by the insulinoma, but the definite location of the tumor could not be determined due to the limitations of conventional imaging, and he was unable to undergo surgical treatment because of his advanced age and chronic kidney disease. After multidisciplinary discussion, we applied cutting-edge imaging examination and emerging endoscopic treatment techniques, and finally solved the problem of diagnosis and treatment of the patient. This process reflects the importance of multidisciplinary cooperation: various disciplines explore the latest technologies and progress in the fields, and jointly assist in the management of complex diseases.作者贡献：陈国榕负责文章撰写及修订；吴东负责提供病例资料、文章构思及修订；阳洪波、罗亚平、吴文铭、孟芝兰、李海龙、张遥、吴晰、杨爱明负责文章修订。利益冲突： 无 -
图 2 患者超声内镜下胰岛素瘤表现
A.2016年12月5日超声内镜发现病灶，胰体尾交界处可见片状偏低回声改变；B.2018年1月29日行超声内镜引导下无水乙醇注射治疗，可见胰尾部实性团块，呈中等偏低回声
表 1 患者饥饿试验结果
指标 时间 5∶00 11∶00 17∶00 23∶00 1∶00 血糖(mmol/L) 3.30 3.30 2.40 2.75 2.42 胰岛素(μIU/mL) 28.83 18.75 15.55 16.39 15.91 C-肽(ng/mL) 6.96 5.81 4.74 4.83 5.32 胰岛素释放指数 0.48 0.31 0.35 0.33 0.36 
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表 2 患者口服葡萄糖耐量试验结果
指标 时间间隔 0 h 1 h 2 h 3 h 血糖(mmol/L) 2.20 10.80 9.40 4.00 胰岛素(μIU/mL) 19.26 44.85 36.84 17.91 C-肽(ng/mL) 3.98 7.82 7.88 5.35
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