徐州医学院学报
徐州醫學院學報
서주의학원학보
ACTA ACADEMIAE MEDICINAE XUZHOU
2015年
3期
204-206
,共3页
肝肿瘤%局灶性结节性增生%诊断%治疗
肝腫瘤%跼竈性結節性增生%診斷%治療
간종류%국조성결절성증생%진단%치료
hepatic tumors%focal nodular hyperplasia%diagnosis%treatment
目的:总结肝脏局灶性结节性增生(focal nodular hyperplasia,FNH)的临床诊断和治疗方法。方法回顾性分析术后病理确诊为 FNH 的13例患者的临床资料,并结合相关文献总结其诊断及治疗要点。结果本组13例患者中,4例患者出现上腹部不适(4/13,30.77%),谷氨酸氨基转移酶升高者5例(5/13,38.46%),天门冬氨酸氨基转移酶升高者2例(2/13,15.38%),CA199升高者1例(1/13,7.69%)。术前临床误诊5例(5/13,38.46%);B 超术前诊断率为 2/11(18.18%),CT 诊断率为 5/13(38.46%),MRI 诊断率为3/7(42.86%)。本组患者均行手术切除,其中局部切除7例,肝段或肝叶切除 4例,半肝切除术2例。术后13例患者均获随访,未发现复发及转移迹象。结论FNH 患者术前临床误诊率较高,CT 和 MRI 是其重要的诊断方法。对病灶较大、术前诊断不明确或伴有肝炎肝硬化的 FNH 患者应行手术治疗。
目的:總結肝髒跼竈性結節性增生(focal nodular hyperplasia,FNH)的臨床診斷和治療方法。方法迴顧性分析術後病理確診為 FNH 的13例患者的臨床資料,併結閤相關文獻總結其診斷及治療要點。結果本組13例患者中,4例患者齣現上腹部不適(4/13,30.77%),穀氨痠氨基轉移酶升高者5例(5/13,38.46%),天門鼕氨痠氨基轉移酶升高者2例(2/13,15.38%),CA199升高者1例(1/13,7.69%)。術前臨床誤診5例(5/13,38.46%);B 超術前診斷率為 2/11(18.18%),CT 診斷率為 5/13(38.46%),MRI 診斷率為3/7(42.86%)。本組患者均行手術切除,其中跼部切除7例,肝段或肝葉切除 4例,半肝切除術2例。術後13例患者均穫隨訪,未髮現複髮及轉移跡象。結論FNH 患者術前臨床誤診率較高,CT 和 MRI 是其重要的診斷方法。對病竈較大、術前診斷不明確或伴有肝炎肝硬化的 FNH 患者應行手術治療。
목적:총결간장국조성결절성증생(focal nodular hyperplasia,FNH)적림상진단화치료방법。방법회고성분석술후병리학진위 FNH 적13례환자적림상자료,병결합상관문헌총결기진단급치료요점。결과본조13례환자중,4례환자출현상복부불괄(4/13,30.77%),곡안산안기전이매승고자5례(5/13,38.46%),천문동안산안기전이매승고자2례(2/13,15.38%),CA199승고자1례(1/13,7.69%)。술전림상오진5례(5/13,38.46%);B 초술전진단솔위 2/11(18.18%),CT 진단솔위 5/13(38.46%),MRI 진단솔위3/7(42.86%)。본조환자균행수술절제,기중국부절제7례,간단혹간협절제 4례,반간절제술2례。술후13례환자균획수방,미발현복발급전이적상。결론FNH 환자술전림상오진솔교고,CT 화 MRI 시기중요적진단방법。대병조교대、술전진단불명학혹반유간염간경화적 FNH 환자응행수술치료。
Objective To summarize the key points concerning the clinical diagnosis and treatment of focal nodular hyperplasia (FNH).Methods Clinical data were collected from 13 patients who were pathologically diagnosed with FNH before retrospective analysis.Then key points involved in FNHˊs diagnosis and treatment were summarized.Results Among all patients discussed, four manifested upper abdominal discomfort (4 /13, 30.77%), while five reported ele-vated ALT (5 /13, 38.46%), two increased AST (2/13, 15.38%), and one elevated CA199 (1 /13, 7.69%).There were five patients who were misdiagnosed before operation (5 /13, 38.46%).The diagnosis rate was 18.18% (2/11) for B -mode ultrasound, 38.46% (5/13) for CT, and 42.86% (3 /7) for MRI before operation.All patients underwent surgical resection, including local resection in 7 cases; segmentectomy or hepatectomy in 4 cases and hemihepatectomy in 2 cases.All patients were followed -up without any recurrence.Conclusion The application of CT and MRI is of im-portance to the diagnosis of FNH due to its high misdiagnosis rate.Surgical treatment is suggested for those FNH patients with large lesions, undiagnosed or accompanied with hepatitis or cirrhosis.