中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
Chinese Journal of Hepatobiliary Surgery
2015年
11期
721-725
,共5页
朱倩%乔国梁%晏建军%严以群
硃倩%喬國樑%晏建軍%嚴以群
주천%교국량%안건군%엄이군
肝血管瘤%自然进程%生长方式%治疗指征%手术
肝血管瘤%自然進程%生長方式%治療指徵%手術
간혈관류%자연진정%생장방식%치료지정%수술
Hepatic hemangioma%Natural history%Growth pattern%Treatment indication%Surgery
目的 探索成人肝血管瘤的自然发展进程和生长方式.方法 从2010年4月至2013年3月,236例未接受过治疗的肝血管瘤成人患者纳入本研究.随访观察肝血管瘤的自然发展进程及出现的并发症.结果 236例肝血管瘤直径0.6～19.2 cm不等,中位大小4.5 cm.在3～266个月的随访期间(中位时间为48个月),61％的患者肝血管瘤增大,23.7％的血管瘤大小无变化,8.5％的肝血管瘤缩小.30岁前为肝血管瘤患者肿瘤生长高峰(0.46±0.41 cm/年),50岁以后肿瘤生长速度明显降低(0.21±0.40 cm/年).小于2.0cm的肝血管瘤生长速度最慢(0.16 ±0.42 cm/年),8.0～10.0 cm的肝血管瘤生长最快(0.80±0.62 cm/年),大于10.0 cm的肝血管瘤生长速度则明显变缓(0.47 ±0.91 cm/年).随访显示9例患者出现明显的与肿瘤相关的症状,没有发现肿瘤相关并发症.结论 绝大多数肝血管瘤均有增大发展趋势,但极少引起并发症.所有肝血管瘤患者均可安全地进行随访.对于症状明显的肝血管瘤患者,手术是最佳治疗方案.
目的 探索成人肝血管瘤的自然髮展進程和生長方式.方法 從2010年4月至2013年3月,236例未接受過治療的肝血管瘤成人患者納入本研究.隨訪觀察肝血管瘤的自然髮展進程及齣現的併髮癥.結果 236例肝血管瘤直徑0.6～19.2 cm不等,中位大小4.5 cm.在3～266箇月的隨訪期間(中位時間為48箇月),61％的患者肝血管瘤增大,23.7％的血管瘤大小無變化,8.5％的肝血管瘤縮小.30歲前為肝血管瘤患者腫瘤生長高峰(0.46±0.41 cm/年),50歲以後腫瘤生長速度明顯降低(0.21±0.40 cm/年).小于2.0cm的肝血管瘤生長速度最慢(0.16 ±0.42 cm/年),8.0～10.0 cm的肝血管瘤生長最快(0.80±0.62 cm/年),大于10.0 cm的肝血管瘤生長速度則明顯變緩(0.47 ±0.91 cm/年).隨訪顯示9例患者齣現明顯的與腫瘤相關的癥狀,沒有髮現腫瘤相關併髮癥.結論 絕大多數肝血管瘤均有增大髮展趨勢,但極少引起併髮癥.所有肝血管瘤患者均可安全地進行隨訪.對于癥狀明顯的肝血管瘤患者,手術是最佳治療方案.
목적 탐색성인간혈관류적자연발전진정화생장방식.방법 종2010년4월지2013년3월,236례미접수과치료적간혈관류성인환자납입본연구.수방관찰간혈관류적자연발전진정급출현적병발증.결과 236례간혈관류직경0.6～19.2 cm불등,중위대소4.5 cm.재3～266개월적수방기간(중위시간위48개월),61％적환자간혈관류증대,23.7％적혈관류대소무변화,8.5％적간혈관류축소.30세전위간혈관류환자종류생장고봉(0.46±0.41 cm/년),50세이후종류생장속도명현강저(0.21±0.40 cm/년).소우2.0cm적간혈관류생장속도최만(0.16 ±0.42 cm/년),8.0～10.0 cm적간혈관류생장최쾌(0.80±0.62 cm/년),대우10.0 cm적간혈관류생장속도칙명현변완(0.47 ±0.91 cm/년).수방현시9례환자출현명현적여종류상관적증상,몰유발현종류상관병발증.결론 절대다수간혈관류균유증대발전추세,단겁소인기병발증.소유간혈관류환자균가안전지진행수방.대우증상명현적간혈관류환자,수술시최가치료방안.
Objective To investigate the natural history and growth pattern of hepatic hemangioma in adults.Methods From April 2010 to March 2013, adult patients with hepatic hemangioma who had no prior treatment were enrolled.A routine follow-up was performed to observe the natural history and complications of these lesions.Results 236 patients were enrolled in the study.The median size of the hemangiomas was 4.5 cm (range 0.6 ～ 19.2 cm).During a median follow-up of 48 months (range 3 ～ 266 months), the hemangiomas increased in size in 61.0％ of patients, remained stable in size in 23.7％, decreased in size in 8.5％.The peak growth period was in patients ＜ 30 years age (0.46 ± 0.41 cm/year) and the growth rate decreased significantly after 50 years of age (0.21 ±0.40 cm/year).Hemangiomas with a size ＜2.0 cm had the lowest growth rate (0.16 ± 0.42 cm/year).The peak growth rate was in hemangiomas 8.0 ～ 10.0 cm (0.80 ± 0.62 cm/year) , but for hemangiomas ＞ 10.0 cm, the growth rate was only (0.47 ±0.91)cm per year.Only 9 patients had severe symptoms caused by the hemangioma.No patients presented with hemangioma-related complications.Conclusions The majority of hepatic hemangiomas have the tendency to increase in size but they rarely caused complications.All the hemangiomas could be safely managed by observation, and surgery should only be considered in patients with complications.
