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玻璃体腔注射曲安奈德治疗非动脉炎性前部缺血性视神经病变的临床观察

26 例胰腺内分泌肿瘤的临床诊治分析

目的 分析胰腺内分泌肿瘤的临床特点并总结治疗经验。 方法 对我院 2004 年 6 月至 2015 年 8 月期间收治且经病理检查确诊的 26 例胰腺内分泌肿瘤患者的临床病理资料进行回顾性分析。 结果 26 例胰腺内分泌肿瘤患者中无功能性胰腺内分泌肿瘤 20 例，功能性胰腺内分泌肿瘤 6 例。实验室血清学检查：4 例功能性胰岛素瘤空腹血糖分别为 1.5、1.6、2.1 及 2.5 mmol/L，空腹血清胰岛素分别为 70、98、105、140 mU/L，饥饿 24 h 后血清胰岛素均≥36 mU/L，空腹 C 肽浓度>11.0 nmol/L；2 例胃泌素瘤患者的基础/高峰胃液分泌量比值分别为 0.72 和 0.78，促胃液素水平分别为 2 800 及 4 200 ng/L。26 例患者行肿瘤标志物检查，其中 2 例恶性无功能性胰腺内分泌肿瘤的 CA19-9>300 U/mL，其余均正常。26 例常规行腹部彩超检查患者中阳性 18 例，胰腺增强 CT 检查 14 例患者中阳性 11 例，MRI 检查 8 例患者中阳性 7 例，超声内镜检查 6 例患者中阳性 6 例。26 例患者均行开腹手术治疗，其中单纯性肿瘤摘除 10 例，胰十二指肠切除术 8 例，节段性胰腺切除 4 例，胰尾部切除 1 例，胰体尾切除 2 例，胰体尾+脾脏切除 1 例。术中见肿瘤位于胰头颈部 7 例，胰体部 9 例，胰尾部 10 例。病理结果证实恶性 14 例，良性 12 例。13 例患者行免疫组织化学检查，其中 CgA 阳性 6 例，Syn 阳性 9 例，NSE 阳性 5 例，CK 阳性 6 例，Insulin 阳性 3 例。本组共发生并发症 11 例，其中 6 例发生胰瘘，1 例腹腔感染，2 例切口感染，1 例胆汁漏，1 例左下肢深静脉血栓形成。21 例获得随访，随访时间 6～120 个月。10 例良性肿瘤患者中有 1 例于术后 5 年死于心肺疾病，其余无复发；11 例恶性肿瘤患者中 9 例仍存活，2 例分别于术后 38、86 个月因肿瘤复发、肝转移死亡。 结论 胰腺内分泌肿瘤的诊断主要采取血清学相关激素水平的测定结合影像学检查，超声内镜能大大提高其诊断率且术前能评估肿瘤的局部浸润程度。手术切除是治疗胰腺内分泌肿瘤的有效方法。

Emergency cosmetic suturing of 210 children with maxillofacial skin lacerations

Objective To analyze the case data of children with maxillofacial skin lacerations and provide a reference for the diagnosis and treatment of maxillofacial skin lacerations in children. Methods The medical records of children with maxillofacial skin lacerations who underwent emergency cosmetic suturing at the Lingang Branch of Yibin Second People’s Hospital between March 2023 and March 2024 were retrospectively collected. The clinical characteristics, diagnosis, treatment, and follow-up of the children were analyzed and summarized. Results A total of 210 children with maxillofacial skin lacerations were included, of which 142 were boys, accounting for 67.62%. The age of the children was most common at 3 years old, accounting for 18.57% (39 cases). A total of 5 children had two lacerations, 3 cases of which were in the same location and 2 cases were not in the same location. The most common site of skin laceration in children was the forehead, accounting for 46.23% (98 cases). The most common cause of maxillofacial skin lacerations was spontaneous falls, accounting for 51.43% (108 cases). The maxillofacial skin lacerations of the children were mainly minor injuries (168 cases, accounting for 80.00%). All children underwent modified vertical mattress suture, and the postoperative satisfaction of the children families was relatively high. Finally, 37 children were successfully followed up, and the follow-up results showed that the wound healing of the maxillofacial skin lacerations were good, the skin scars were not obvious, and the appearance of the skins were basically normal. Conclusion For children with maxillofacial skin lacerations, using the modified vertical mattress suture for emergency cosmetic suturing is beneficial for their injury recovery and facial aesthetics.