肝局灶性结节性增生的诊断与外科治疗

Diagnosis and surgical treatment of focal nodular hyperplasia of liver.\

目的 探讨肝局灶性结节性增生 (FNH )的临床诊断与外科治疗指征。方法 回顾性分析 1995～1999年以来收治的 17例FNH并复习文献进行分析。结果 术前超声、CT检查均未确诊本病 ,2例经超声引导下穿刺活检而获得明确病理诊断。 15例行手术切除 ,术后恢复良好 ,无手术并发症。结论 FNH的发生可能与肝先天性血管畸形形成血流高灌注有关。FNH临床鉴别诊断极其困难 ,超声引导下穿刺活检可获明确病理诊断。无症状的FNH无须手术治疗 ,但当结节直径 >5cm ,病人有症状时 ,或结节位于中肝 ,压迫门静脉、下腔静脉时 ,或性质未明 ,不能排除肝细胞癌 (HCC)

ObjectiveTo assess the clinical diagnosis and surgical in dications of focal nodular hyperplasia(FNH) of liver.MethodsSevent een cases with FNH treated in our department in the past 4 years(1995～1999)were studied retrospectively,and the clinical data and related literatures were revi ewed.ResultsPreoperative diagnosis could not be confirmed by the m eans of ultrasonography and CT.Two cases were diagnosed by biopsy guide d by ultrasonography.Fifteen cases underwent resection and no postoperative com plication occurred.ConclusionBlood hyperfusion induced by hepatic congenital vascular malformation may contribute to FNH's pathogenesis.The diff eren tial diagnosis of FNH is very difficult.Biopsy guided by ultrasonography is a co nvenient way to confirm the diagnosis.Asymptomatic FNH need no operation,but surgical resection is peroformed in the following conditions:diameter of the no dulu s is beyond 5cm and with symptome,portal vein or inferior vena cava oppresse d by the mass,and difficulty in excluding hepatocellular carcinoma and adenoma.