發(fā)布時間：2019-01-23 13:30

【摘要】：目的總結肝臟局灶性結節(jié)增生(FNH)的臨床特點,以提高對FNH的認識。方法采用回顧性研究的方法,收集福建醫(yī)科大學附屬協(xié)和醫(yī)院2005年3月至2014年12月期間手術切除的病理確診為FNH的病例資料。統(tǒng)計描述本組病例的人口學特征、臨床表現特點、影像檢查的敏感性、病灶形態(tài)學特征以及手術情況等。結果本組病例共收集了91例FNH患者的臨床資料,其中男性49例,女性42例,男女比例1.17:1,年齡15~63歲,中位年齡34歲。無臨床癥狀的病例占91.7%,因腹痛而就診的病例占5%。術前r-谷氨酰轉移酶(GGT)、谷氨酸轉氨酶(ALT)升高的病例分別占全部病例的33.0%、14.3%。影像學檢查中,MRI、CT、超聲檢查的敏感性分別為60.3%、43.8%、32.9%。病灶形態(tài)學的特點包括:單發(fā)病灶占92.3%、外生性占52.5%,病灶內中央星芒狀瘢痕占32.7%,病灶≤3cm、3cm~5cm、5cm者分別占38.6%、33.7%、27.7%。手術方式:腹腔鏡手術10例(11.0%),其中局部切除術5例,肝葉切除術5例;開腹手術81例(89.0%),其中局部切除術66例,肝葉或半肝切除術15例。術中平均出血量為109.2±95.7ml,術后并發(fā)癥發(fā)生率為9.9%,無圍手術期死亡病例。手術原因大致可以分為四類:(1)不能排除惡性腫瘤的病例占61%;(2)患者心理負擔較大的病例占30%;(3)明顯腹痛的病例占7%;(4)合并其他手術(膽囊切除術)的病例占2%。結論FNH多發(fā)于青年,本組的男性病例略多于女性,臨床癥狀少。病灶≤3cm者多見,以單發(fā)、外生性為主。MRI檢查的敏感性高于CT、超聲檢查。手術方式為局部切除病灶或規(guī)則性肝切除。
[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，

本文編號：2413822