肝脏局灶性结节性增生临床诊治分析  

Clinical diagnosis and treatment of focal nodular hyperplasia of the liver

作　　者：孙俪洋 高恒军 卢俊[1] Sun Liyang;Gao Hengjun;Lu Jun(Department of Hepatobiliary Surgery,Shandong Provincial Hospital,Shandong Jinan 250014,China)

机构地区：[1]山东省立医院肝胆外科

出　　处：《腹部外科》2019年第6期408-412,共5页Journal of Abdominal Surgery

基　　金：国家自然科学基金(81802379)

摘　　要：目的分析肝脏局灶性结节性增生(focal nodular hyperplasia,FNH)的临床诊断及治疗效果。方法收集山东省立医院2010年1月至2018年12月收治的78例FNH病例的临床资料,结合临床病理结果及随访分析临床诊断及手术治疗效果。结果78例FNH病人中,64例病人初诊时即行手术切除治疗,术后病理诊断证实临床诊断;14例病人通过典型影像学表现临床诊断,后临床密切随访,其中3例病人病灶增大,行进一步手术切除治疗,其余病人未见明显变化甚至病灶缩小。在总共67例手术治疗病人中,45例病人行腹腔镜手术切除,22例病人行开腹手术切除,总体术后并发症发生率为4.48%,腹腔镜手术相对于开放手术,其可以显著降低手术并发症和减少住院时间(P<0.05)。术后中位随访时间2.1年,未见病灶复发。结论FNH是临床常见肝脏良性肿瘤,典型FNH经CT、MRI等影像学检查可确诊,手术切除是临床治疗FNH有效治疗方法。对于病灶较小、临床无明显症状、临床诊断明确的FNH,观察随访则不失为一种合理的处理方式。Objective To analyze the clinical diagnosis and management of focal nodular hyperplasia(FNH)of the liver.Methods The clinical data of 78 cases of FNH of the liver were collected,so as to analyze the clinical diagnosis and surgical treatment effect.Results Of the 78 patients with FNH,64 patients underwent surgical resection at the time of initial diagnosis.The clinical diagnosis was proved by the postoperative pathological result.Fourteen patients were diagnosed through the typical imaging features,and then wre closely followed up.Three patients underwent further surgical resection due to enlargement of the lesion.The rest of the patients did not show significant changes or even reduction in lesion size.Of the total 67 patients treated surgically,45 patients underwent laparoscopic resection and 22 patients underwent open resection,with an overall postoperative complication rate of 4.48%.Laparoscopic surgery significantly reduced surgical complications and hospital stay compared with open surgery(P<0.05).After a median follow-up of 2.1 years,no recurrence of the lesion was observed.Conclusion FNH is a common benign tumor of the liver.Typical FNH can be diagnosed by CT and MRI imaging.Surgical resection is an effective treatment for FNH.For FNH with small lesion,no obvious clinical symptoms and definite clinical diagnosis,observation and follow-up is a reasonable management.

关 键 词：肝脏良性肿瘤 局灶性结节性增生 诊断 治疗 

分 类 号：R657.3[医药卫生—外科学]