尿路結核の治療と予後に関する研究

抄録

Concerning the patients taken into this department from 1950 to June, 1956, I made a statistical observation, especially on the transfiguration caused by antitubercle drugs, on the medical treatment and the prognosis, on the effect of antitubercle drugs on the tubercular renal tissue and also a study on the antibiotic resistent tubercle bacilli in urine against the drugs. Above all, it was the chief object of this study to investigate the dose and the term of administration of antitubercle drugs and to investigate the definit method of postoperative management to secure the permanent recovery after the operation on the unilateral renal tuberculosis.
Clinical Statistics:
1) The actual number of renal tubercular patients treated during the term from 1950 to June, 1956 was 291-179 (61%) cases of male and 112 (39%) cases of female patients—that is, male patients were nearly twice female ones. The number of one-kidney tuberculosis was 226 (39%) and that of both-kidney tuberculosis was 61 (21%), there being no difference in number between the right and the left kidney. During this term, the total number of renal tuberculosis was 333 (7, 1%) against the 4661 outpatients who came to this urological department. When classified by year the ratio of outpatients has been on a slight decrease, while the actual number has been on a slight increase. When investigated by age group, out of 280 cases, 124 were found in “twenties” (the greatest in number) and 232 (83%) in the age group of 11-40 (majority).
2) Symptoms; Out of 268 cases, those showing only vesical symptom or accompanying hematuria were 175 (65. 3%), those without any symptom being 29 (10.8%). Out of 183 patients who never used antitubercular drugs those complaining of trias were 146 (79. 8%), while out of 85 patients who used the drugs those complaining of the same were 29 (34. 1%). Out of 183 patients who never used the drugs, there was only 1 case (0.6%) without any symptom, while out of 85 patients who used the drugs there were 28 (32.8%). According to the investigation classified by year, those without any symptom are increasing in number year after year—that is, among those who used antitubercular drugs, the patients complaining of trias and those without any symptom are increasing remarkably. As to the interval between the nosogenesis of bladder symptom and the visit to the hospital, out of 213 cases, 113 (52.6%) were within 3 months and 158 (74%) were within 6 months.
3) Degree of the bladder lesion: Out of 209 cases to which cystoscopy was applicable, those of great degree were 33 (13.7%), those of medium degree 101 (42.1%), and those of slight degree 75 (31.2%). According to the investigation classified by year, those of slight degree are on the increase year after year. Out of 176 patients who used antitubercular drugs those with slight degree were 17 (9.7%), those with medium degree 106 (60.2%), and those with great degree 32 (18.2%). Out of 64 patients who used the drugs, those with slight degree were 29 (45.3%), those with medium degree 24 (37.5%), and those with great degree 1 (1.6%). This fact shows that among the drug-using group those with slight degree are remarkably great in number.
4) Chromocystoscopy: Out of 230 cases of diseased kidney, those which secreted indigocarmin within 10 minutes were 73 (31.8%), those of no secretion 157 (68.2%). Classifying the degree of positivity in the former group into ‘high’, ‘medium’ and ‘low’, they were 28, 24, and 21 in number respectively.
5) Detection rate of tubercular bacilli in urine: Out of 255 cases, those of positivity were 177 (69.4%). Out of 170 patients who used antitubercular drugs, those of positivity were 33 (47.1%) and those of negativity 37 (52.9%), both being nearly the same in percentage. Out of 185 patients who never used the drugs, those of positivity were 144 (77.8%) and those of negativity 41 (22.2%), which fact shows a remar