肝局灶性结节增生的临床特点及诊疗分析

发布时间：2019-01-23 13:30

【摘要】：目的总结肝脏局灶性结节增生(FNH)的临床特点,以提高对FNH的认识。方法采用回顾性研究的方法,收集福建医科大学附属协和医院2005年3月至2014年12月期间手术切除的病理确诊为FNH的病例资料。统计描述本组病例的人口学特征、临床表现特点、影像检查的敏感性、病灶形态学特征以及手术情况等。结果本组病例共收集了91例FNH患者的临床资料,其中男性49例,女性42例,男女比例1.17:1,年龄15~63岁,中位年龄34岁。无临床症状的病例占91.7%,因腹痛而就诊的病例占5%。术前r-谷氨酰转移酶(GGT)、谷氨酸转氨酶(ALT)升高的病例分别占全部病例的33.0%、14.3%。影像学检查中,MRI、CT、超声检查的敏感性分别为60.3%、43.8%、32.9%。病灶形态学的特点包括:单发病灶占92.3%、外生性占52.5%,病灶内中央星芒状瘢痕占32.7%,病灶≤3cm、3cm~5cm、5cm者分别占38.6%、33.7%、27.7%。手术方式:腹腔镜手术10例(11.0%),其中局部切除术5例,肝叶切除术5例;开腹手术81例(89.0%),其中局部切除术66例,肝叶或半肝切除术15例。术中平均出血量为109.2±95.7ml,术后并发症发生率为9.9%,无围手术期死亡病例。手术原因大致可以分为四类:(1)不能排除恶性肿瘤的病例占61%;(2)患者心理负担较大的病例占30%;(3)明显腹痛的病例占7%;(4)合并其他手术(胆囊切除术)的病例占2%。结论FNH多发于青年,本组的男性病例略多于女性,临床症状少。病灶≤3cm者多见,以单发、外生性为主。MRI检查的敏感性高于CT、超声检查。手术方式为局部切除病灶或规则性肝切除。
[Abstract]:Objective to summarize the clinical features of hepatic focal nodular hyperplasia (FNH) in order to improve the understanding of FNH. Methods A retrospective study was conducted to collect the data of patients with FNH confirmed by surgical excision from March 2005 to December 2014 in the Union Hospital affiliated to Fujian Medical University. The demographic characteristics, clinical manifestations, sensitivity of imaging, morphologic features and surgical conditions of the patients were statistically described. Results the clinical data of 91 patients with FNH were collected, including 49 males and 42 females, the ratio of male to female was 1.17: 1, the age was 1563 years old, the median age was 34 years old. No clinical symptoms were found in 91.7 cases, and abdominal pain accounted for 50.0%. Preoperative r-glutamyltransferase (GGT), glutamate transaminase (ALT) increased in 33. 0% of all cases. In imaging examination, the sensitivity of MRI,CT, ultrasonography was 60.3 and 43.8 respectively. The morphologic features of the lesions included: 92. 3% of the single lesions, 52. 5% of the exogenetic lesions, 32. 7% of the central stellate scar in the focus, 38.633. 7% of the lesions 鈮，

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