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find Keyword "局灶性结节性增生" 5 results
  • Diagnosis and Treatment for Hepatic Focal Nodular Hyperplasia (Report of 21 Cases)

    目的 探讨肝脏局灶性结节性增生(FNH)的临床诊断与治疗,以提高对FNH的认识。方法 回顾性分析我院普通外科2004年7月至2011年7月期间收治的21例经术后病理证实为FNH的临床资料。结果 本组21例FNH患者中男6例,女15例,平均年龄31.1岁。单发19例,多发2例。9例为体检发现,无不适症状;12例有右上腹隐痛不适症状,均无肝炎、肝硬变病史;1例女性患者有长期口服雌激素病史。化验检查:谷丙转氨酶轻度升高1例,其余肝功能检查、肿瘤标志物及HBsAg均为阴性。术前影像学检查诊断符合率:彩超检查为42.9% (6/14),CT检查为50.0% (6/12),MRI检查为38.5% (5/13)。术后均恢复良好,随访至今无复发。结论 FNH术前确诊率仍较低,主要依赖术后病理学检查。对于术前诊断不明确、病灶巨大或有临床症状者仍应采取手术切除治疗。

    Release date:2016-09-08 10:34 Export PDF Favorites Scan
  • 18 例少见肝占位性疾病的诊治分析

    目的 总结少见肝占位性病变的诊治体会。 方法 回顾性分析 2009 年 6 月至 2016 年 4 月期间遵义医学院附属医院收治的 18 例少见肝占位性病变患者的临床资料。 结果 18 例患者中,包括肝结核 4 例,肝血管平滑肌脂肪瘤(HAML) 3 例,肝局灶性结节性增生(FNH) 4 例,肝腺瘤 1 例,肝寄生虫病 6 例,所有患者的影像学图像均表现为肝占位性病变。4 例肝结核患者经正规抗结核治疗好转出院;2 例肝肺吸虫病患者接受吡奎酮正规驱虫治疗,随访期间无异常;1 例血吸虫病患者行手术治疗后治愈出院,未获得随访;3 例寄生虫感染患者行手术切除病变部位,随访期间无异常;3 例 HAML 患者行手术治疗,随访期间病情无明显异常,4 例 FNH 患者行手术治疗,2 例随访期间未见明显异常,2 例未获得随访;1 例肝腺瘤患者行手术治疗,随访无明显异常。出院后 15 例患者获访,随访时间 2~6 个月,中位数为 3.5 个月。随访期间,除 4 例肝结核患者因抗结核治疗引起相应并发症、经保守治疗好转外,其余患者均未见明显并发症发生。 结论 大多数少见肝占位性病变术前诊断较困难,熟悉掌握疾病相关特点及影像学表现,可降低误诊率,但明确诊断主要依靠病理学检查,治疗以手术为主。

    Release date:2017-04-01 08:56 Export PDF Favorites Scan
  • Diagnosis and treatment of hepatic focal nodular hyperplasia (Analysis of 22 cases)

    Objective To summarize manifestation, imaging characteristics, and treatment of hepatic focal nodular hyperplasia (FNH). Methods From January 2007 to December 2016, the patients pathologically confirmed hepatic FNH were included in this study. The clinical features and imaging characteristics were analyzed retrospectively. Results Twenty-two cases were pathologically diagnosed as hepatic FNH with an age of (36.8±11.2) years (range from 20 to 61 years). Ten were males and 12 were females. Three patients had abdominal pain and 19 patients had no symptoms. The diameter of the lesions was (4.16±1.92) cm (range from 1.0 to 7.8 cm) and approximately 9 (40.9%) lesions were more than 5.0 cm. The diagnosis rates of CT and MRI were 64.70% (11/17) and 84.21% (16/19), respectively. All the patients underwent hepatectomy successfully and recovered without severe complications. No recurrence and metastasis happened during following-up of 1–103 months. Conclusions Hepatic FNH is more common in young patients and has no typical symptoms. MRI is useful in diagnosis of hepatic FNH.

    Release date:2017-05-04 02:26 Export PDF Favorites Scan
  • Clinical analysis of 31 patients with hepatic focal nodular hyperplasia

    Objective To summarize clinical features, imaging findings, diagnosis, treatment, and prognosis of patients with hepatic focal nodular hyperplasia. Method The clinical data of patients with hepatic focal nodular hyperplasia who underwent hepatectomy from July 2014 to July 2016 in the Xiangya Hospital of Central South University were analyzed retrospectively. Results There were 12 males and 19 females in the 31 patients with hepatic focal nodular hyperplasia, the male-to-female ratio was 1∶1.58. The age was from 15 to 67 years old with (39.7±11.5) years old. Physical examination found 21 cases, there were symptoms in 10 cases. Laboratory examination: only 2 patients with long-term drinking history had mild AST abnormality, HBsAgs of 6 cases were positive, CA19-9 level of one patient was slightly increased (40.54 kU/L). Thirteen patients with hepatic focal nodular hyperplasia were diagnosed by imaging examination, the diagnostic rate of MRI was significantly higher than that of color Doppler ultrasound (P<0.05) or CT (P<0.05). The diameter of the lesions ranged from 2 cm to 11 cm with (4.6±2.1) cm. All lesions were resected, including 13 cases by laparoscopic hepatectomy, and 18 cases by laparotomy. Compared with by the laparotomy, the intraoperative blood loss was less (P<0.05), the hospital stay and intestinal exhaust time were shorter (P<0.05) by the laparoscopic hepatectomy. Twenty-nine patients were followed up from 3 to 24 months, no patient died, the quality of life was better, no recurrence and metastasis happened. Conclusions Hepatic focal nodular hyperplasia is benign lesion, it has a good prognosis, generally without clinical symptoms, its laboratory feature has no abnormality. The combination of multiple imagings and pathological diagnosis could improve diagnosis rate. Surgical resection should be performed for suspected malignant tumor or other hepatic occupying lesions. Laparoscopic surgery has some advantages of quick recovery and less bleeding for it.

    Release date:2017-05-04 02:26 Export PDF Favorites Scan
  • Combined laparoscopic and interventional therapy for congenital portosystemicshunt with hepatic focal nodular hyperplasia

    ObjectiveTo summarize the treatment of a patient with congenital portosystemic shunt (CPS) complicated with hepatic focal nodular hyperplasia (FNH), and to explore the feasibility and safety of combined laparoscopy and interventional radiology therapy at the same time.MethodsThe clinicopathological data of a patient with CPS complicated with hepatic FNH who admitted to West China Hospital of Sichuan University in March 2019 was retrospectively analyzed.ResultsThe patient underwent laparoscopic liver nodule resection and digital subtraction angiography (DSA) guided jugular portal portosystemic shunt fistula embolization. The laparoscopic surgery operation time was 180 min and the intraoperative blood loss was 50 mL, and for interventional procedure was 230 min and 10 mL respectively. There were no complications after operation and the patient was successfully discharged on the 8th day after surgery. The patient was followed up for six months and in good condition.ConclusionsCPS patient should develop individualized treatment under the discussion of multidisciplinary cooperation group. The combination of laparoscopy and interventional technique can be minimally invasive and efficient to solve portal vein-avitary shunt fistula and benign hepatic nodules at the same time.

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