目的 总结对肝脏局灶性结节增生（focal nodular hyperplasis,FNH）的临床诊治经验,提高对FNH的认识。方法 回顾性分析我院外科2010年10月至2017年1月收治的22例FNH病人,术后病理均证实为FNH。结果 22例FNH病人中,男12例,女10例,男女比1.2∶1.0,平均年龄（32.50±8.38）（18~50）岁。3例病人因上腹痛至医院检查发现,1例因体检发现CA-724升高就诊,其余病人均无临床症状。术前影像学检查诊断为FNH者17例。所有病人均接受手术治疗,平均手术时间（142.72±54.81）（50~300） min,术中平均出血量（397.27±466.95）（50~1 700） mL,平均住院天数（7.90±2.86）（4~15） d,所有病人均无严重并发症,无围术期死亡病人,术后随访11~75个月均未见复发。结论 FNH是较少见的肝脏良性增生性病变,多无明显临床症状,中央瘢痕为其特征性表现,联合多种影像学检查对本病的诊断具有较大价值。对于有明显临床症状,与肝癌及肝腺瘤难以鉴别,合并肝炎肝硬化的病人应积极手术,其预后较好。
Objective To review the experience of diagnosis and treatment of focal nodular hyperplasia (FNH) in our department for the management of FNH represents a challenge. Methods Twenty-two cases with FNH from October 2010 to January 2017 were studied retrospectively. All patients were diagnosed as FNH by postoperative pathological assessment. Results Twelve male cases and 10 female cases with FNH were recruited with sex ratio 1.2∶ 1.0 and mean age (32.50± 8.38)(18-50) years. Three cases manifested clinical symptoms with 3 cases of abdominal pain and one case of high CA-724 level. The others had no any symptoms. Seventeen cases were diagnosed as FNH by imaging. All cases received surgical therapy with operating time (142.72± 54.81) (50-300) min, operative blood loss (397.27± 466.95) (50-1 700) mL and hospital stay(7.90± 2.86) (4-15) days, There was no both severe morbidity and mortality peri-operatively and no recurrent case was found during the period of follow-up from 11 to 75 months. Conclusions FNH is a rare benign proliferative lesion of liver with rare clinical symptoms and characterized by central scar. Combination of several imaging modalities would be valuable to the diagnosis. For the patients with symptomatic FNH, combined with hepatitis and cirrhosis or difficult to distinguished from hepatic cancer or hepatic adenoma, surgical resection should be considered and the prognosis is better.
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