[Anesthetic management of pediatric patients with insulinoma using continuous glucose monitoring].
[Anesthetic management of pediatric patients with insulinoma using continuous glucose monitoring].
复制标题
[使用连续血糖监测对胰岛素瘤儿科患者进行麻醉管理]。
DOI：
--
复制
发表时间：
2009
期刊：
影响因子：
--
通讯作者：
K. Morita
中科院分区：
文献类型：
--
作者：
M. Manabe;H. Morimatsu;M. Egi;Satoshi Suzuki;R. Kaku;M. Matsumi;K. Morita
胰岛素瘤是一种罕见的肿瘤，其发病率为百万分之一至二。胰岛素瘤患者会出现继发于胰岛素分泌过多的低血糖症状。手术切除是一种选择的治疗方法，也是唯一的治愈机会。麻醉中的重点是肿瘤切除前预防低血糖和肿瘤切除后迅速控制高血糖反弹。我们报告一名 5 岁胰岛素瘤患者的麻醉管理情况。麻醉诱导后不久，开始连续血糖监测。肿瘤切除前需输注10%葡萄糖以避免低血糖。然后继续输注胰岛素，维持血糖水平在150 mg·dl(-1)左右。所有血糖管理均以连续血糖监测为指导。这是第一份案例报告，展示了连续血糖监测在儿科胰岛素瘤患者管理中的可行性和有用性。由于围手术期血糖发生显着变化，因此在胰岛素瘤切除围手术期必须频繁测量血糖或持续监测血糖。
Insulinomas are rare tumors, the incidence of which is 1-2 per million. Patients with insulinomas present with symptoms of hypoglycemia secondary to insulin hypersecretion. Surgical resection is a treatment of choice and offers the only chance of cure. The important points in anesthesia are the precaution against hypoglycemia until tumor resection and the control of rebound hyperglycemia soon after tumor resection. We report the anesthetic management of a 5-year-old patient with insulinoma. Soon after the induction of anesthesia, the continuous glucose monitoring was commenced. Until the tumor resection, 10% glucose infusion was required to avoid hypoglycemia. Then, insulin infusion was continued to maintain blood glucose level around 150 mg x dl(-1). All glucose management was guided with continuous glucose monitoring. This is a first case report to show the feasibility and usefulness of continuous glucose monitoring in management of pediatric insulinoma patients. As the blood glucose was dramatically altered during perioperative period, frequent blood glucose measurements or continuous glucose monitoring is mandatory during perioperative period of insulinoma resection.