肺結核症に合併する気管枝拡張の諸因子 (特に化学療法と病型の推移との関係)

抄録

Employing a total of 499 cases of pulmonary tuberculosis patients, observations were made on the changes produced in the pulmonary lesions in relation to the presence or absence of and the form of bronchiectasis complication. Pathological investigations were made, further, on various factors participating in the development of bronchiectasis complication on the 68 cases of pulmonary resection out of the above mentioned 499.
Distribution of ectasis was numerouns especially on B¹ and B², followed by B⁶ on the right and B³, B⁴, B⁵ and B⁶ on the left side in the order listed.
Classification proposed by the committee of chemotherapy for tuberculosis, Ministry of Education (CCT) showed no correlation to the kind, the time started and the duration of chemotherapy employed.
Only a small number of strong bronchiectasis were found among the patients who responded to the chemotherapy with the diminish of lesions or the disappearance of cavity on X-ray pictures, while were a number of strong bronchiectasis among the patients with persisting cavity. A larger number of bronchiectasis were recognized among the patients of T and Kd groups and those having fibrotic lesions without cavity than among the patients having infiltrative lesions without cavity. In the majority, the bronchiectasis observed was like a rod in shape.
As the result of pathological investigation made on the excised lung, it was found that the ectasis of the douche or the segmental bronchus is closely related to the cavity and other ectasis to the apneumatic lung. Both strong and weak ectasis are caused by the same factors of only quantitative difference.
Condensation, clearance, cicatrization and caseation of the cavity were observed slightly more in number among the patients with weak ectasis being in good agreement with X-ray findings. In many cases of the patients with strong bronchiectasis, the ectasis of the douche bronchus exists together with ectasis of other bronchi, while in case of weak bronchiectasis, involvement of the ectasis other than douche bronchus is rare.