対標比肺活量よりみた肺結核症の推移
1961 年 21 巻 3 号 p. 304-318
詳細
1961 年 21 巻 3 号 p. 304-318
In order to observe pulmonary tuberculosis from the standpoint of functions, pulmonary lesions, pleural thickening, bronchograms and electrocardiograms were investigated making comparisons with the general standard vital capacity and at the same time pathological surveys were made on the causes of death.
A total of 435 cases including 7 fatal cases were selected. They had been under observation for a period of 1 year and had not received any surgical treatment for additional 1 year being under chemotherapy alone.
Evident parallel relationship was observed between the %VC and the classification of the disease types proposed by the American National Tuberculosis Association (NTA) when the clinical symptoms of the patients became stable by the treatment continued for 1 year. %VC of moderate cases (NTA) showed a remarkable increase during an observation period of 1 year and advanced cases (NTA) with VC over 80% followed a favourable clinical course. Factors causing this increase in %VC were found to be the effect of chemotherapy on the patients of exudative and cheesy infiltrative (Gakken), disappearance and diminish of the cavity, increase in the body weight, and early treatment.
As for the relationship of %VC and pleural thickening, there was a close correlation in either case of the thickening of single side or both sides when the thickening was advanced.
While, no distinct correlation was observed between %VC and bronchiectasis except the presence of lowering tendency among the patients with strong ectasis.
The relationship of %VC and electrocardiogram, moreover, the patients who showed stronger lowering in %VC, in most cases, showed stronger right ventricular hypertrophy.
Autopsy findings showed that the death causes were the penumonia and the asphyxia caused by haemoptysis complicated in the patients with poor pulmonary functions.
In view of the findings stated above, an emphasis was made on the importance of the observation of pulmonary functions for the observation of the clinical course of pulmonary tuberculosis patients aside from the X-ray observation of the tuberculous lesions.
