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成人肝血管瘤:自然史及处理

Adult liver hemangioma: natural course and treatment

摘要:

目的 探讨成人肝血管瘤(adult liver hemangioma,ALH)自然史及处理对策.方法 分析超声诊断ALH 2422例临床资料.结果 男女比1∶1.02(1197/1225),年龄16~69(42.9±11.4)岁.30岁以后各年龄组患病率明显升高,以40~69岁年龄组患病率最高.右肝、单发、1.1~3.0 cm病灶最常见.男性患病年龄高于女性,女性瘤体直径大于男性、合并疾患多于男性.1427例有3~8次超声随访.在平均(42.7±9.5)个月的门诊随访记录显示1351例瘤体无明显变化,76例瘤体增大,154例接受手术或介入治疗.结论 ALH有随年龄增加增多趋势.性激素似乎仅促进ALH生长而非促进其发生.多数ALH生长缓慢、不需治疗.有症状时ALH应注意并存疾病的筛检.

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Objective To investigate the natural course and treatment of adult liver hemangioma (ALH).Methods The records of ultrasonography of 2422 patients with ALH were retrospectively reviewed.Results The patients were between 16 and 69 years of age (mean age 42,9± 11.4) with a male to female ratio of 1 ∶ 1.02 (1197/1225).The prevalence rate gradually increased with age after 30 years old.The highest prevalence rate occurred between 40-69 years.ALH was most commonly 1.1-3 cm in size,located in right liver with a solitary lesion.ALHs were bigger and were seen earlier in females than males.Concurrent illness was also more common in females than males.1427 patients had 3 to 8 repeat sonographies.At a follow-up of 42.7±9.5 months,1351 patients had no change in the ultrasonographic pattern or number of haemangiomas.Increasing in size of the lesions was demonstrated in 76 patients.154 patients received operation or interventional treatment.Conclusions The prevalence rate of ALH rose with age.Female sex hormones might accelerate ALH enlargement but they did not induce the formation of ALH.Most ALH remained stable in size and in patterns.Attention should be paid to rule out other illnesses in patients with ALH and with symptoms.

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