摘要
目的探讨肝脏局灶性结节性增生（focal nodular hyperplasia，FNH）的临床特点、诊治原则与经验。方法回顾性分析北京大学第一医院外科2004年4月至2011年4月收治的42例经病理学检查证实的肝脏局灶性结节增生患者的临床资料，其中38例经手术切除病理证实，另4例经穿刺活检确诊。结果本组42例患者中男25例，女17例，年龄14～51岁，多无明显症状（95．2％），肝功能正常者占97．6％；FNH的影像学特征性为中央瘢痕和轮辐状改变。38例患者行手术切除，其中肝叶切除16例（左外叶9例，左内叶3例，左内叶＋部分右叶1例，右叶3例），不规则局部切除20例（左侧11例，右侧8例，左侧＋右侧1例），肿物摘除2例。术后均恢复良好，无手术并发症，术后经随访6—90个月均无复发；4例患者经穿刺活检确诊后定期影像学观察，随访27～88个月，病灶无明显增大。结论FNH是一种肝脏良性病变，对于诊断明确且无临床表现者，可定期随诊。对于有上腹部不适、疼痛及明显压迫症状及不能除外恶性肿瘤者，可手术治疗。
Objective To investigate the clinical features, diagnosis and treatment of focal nodular hyperplasia （FNH） of the liver. Methods Clinical data of 42 FNH patients confirmed by pathology at our hospital between 2004 and 2011 were analyzed retrospectively. Thirty-eight cases underwent resection, and the other 4 patients were diagnosed by liver biopsy. Results The 42 cases consisted of 25 males and 17 females, and age ranged from 14 to 51 years. Most of the patients （95.2%） had no significant clinical symptoms, and the liver function test was normal in 97.6% （41/42） patients. The typical imaging features of FNH was the central scar and the radiating pattern. Thirty-eight cases underwent liver resection without any postoperative complication, and no recurrence was observed within 6 -90 months of follow up. For the other 4 cases, observation with periodic imaging follow up was performed after liver biopsy for 27 - 88 months without changes in all the lesions. Conclusions FNH is a benign tumor of the liver. Observative follow up is recommended for asymptomatic patients with a definite diagnosis preoperatively. Surgical resection should be performed for symptomatic patients （ epigastric pain or discomfort）, or for patients with a suspicion of malignancy.
出处
《中华普通外科杂志》
CSCD
北大核心
2012年第4期292-294,共3页
Chinese Journal of General Surgery
关键词
肝肿瘤
局限性结节状增生
诊断
治疗
Liver neoplasms
Focal nodular hyperplasia
Diagnosis
Treatment
