肝脏局灶性结节性增生20例的诊断和治疗  

The diagnosis and treatment of 20 patients with hepatic focal nodular hyperplasia

作　　者：叶青海[1] 马曾辰[1] 吴志全[1] 汤钊猷[1] 樊嘉[1] 钦伦秀[1] 

机构地区：[1]上海医科大学肝癌研究所,中山医院,200032

出　　处：《中华普通外科杂志》2001年第4期201-203,共3页Chinese Journal of General Surgery

摘　　要：目的　探讨肝脏局灶性结节性增生 (Focalnodularhyperplasia ,FNH)的诊断和治疗。方法　回顾性分析本所 1996年 5月至 1999年 5月经手术和病理学检查证实的 2 0例FNH的临床、影像、手术及病理学资料。结果　 80 % (16 /2 0 )FNH为 45岁以下青壮年 ,70 % (14/2 0 )无症状 ,AFP均为阴性 ,15 %有肝炎感染证据。 85 % (11/13)在彩色超声见到特征性的粗大中央血管 (1～ 3mm) ;CT动态扫描 75 % (12 /16 )早期显著增强 ,MRI检查 83 % (10 /12 )增强后早期明显强化 ,2 0例病人共 2 8个FNH病灶 ,93% (2 6 /2 8)病灶小于 5cm、无包膜 ,2 0例均经手术切除病灶 ,无手术死亡及严重并发症。结论FNH在临床及影像学上有一定特征 ,如能在术前获明确诊断则可密切随访。Objective To study the diagnosis and therapy for hepatic focal nodular hyperplasia(FNH). Methods To analyse retrospectively the clinical、imaging、 operative and pathological materials in 20 patients with FNH proved by operation and pathology during May 1996 to May 1999 in our institute.Results 80% (16/20) of patients with FNH were under 45 years of age. 70%(14/20) of patients were asymptomatic. AFP was negative in all patients. Hepatitis B/C was negative in 85%(17/20) of patients. A big central artery was found in the lesion in 85%(11/13) of patients by color Doppler ultrasound. CT scan showed transient immediate enhancement in 75%(12/16) of patients. MR imaging demonstrated early vigorous enhancement in 83% (10/12) of patients.93%(26/28) of the lesions were less than 5 cm in diameter and non encapsulated. All patients underwent focus resection, and there was not mortality and severe complication.Conclusion [WT5”BZ] FNH shows some typical clinical and imaging features, therefore, it is feasible to be diagnosed in some of the patients by the combination of multi modalities. Close observation should be recommended for asymptomatic patients with unequivocal diagnosis. However, for those with equivocal diagnosis or with symptoms or with lesion enlargement, surgical resection should be performed.

关 键 词：诊断 临床方案 肝脏局灶性结节性增生 外科治疗 

分 类 号：R735.7[医药卫生—肿瘤]