肺結核に於ける気管支造影像の臨床的研究 : 特に気管支瘻の発生原因について
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Bronchograms taken in pre- and postoperative periods were examined, and the specimens of resected lungs were studied histopathologically in 87 patients with pulmonary tuberculosis who had been operated on with resection of the lung. The following conclusions were reached. A. Bronchographic changes of the bronchial walls seem to represent the degree of bronchial involvement by tuberculosis. In cases where pathologic examinations showed evidence of bronchial involvement of high degree, the bronchial mucosa was jagged in contour, with high pointed teeth. Bronchograms showed indentation in the bronchial walls of these cases. B. Bronchograms generally showed either conical or irregular stumps of the bronchi, or showed a leak of contrast medium near the stumps, when patients had had positive-sputum before operation, the specimens of resected lung showed bronchial involvement in the stumps, and bronchograms had shown indentation in the bronchial walls at a point where excision was made. C. Bronchopleural fistula may develop postoperatively if there is bronchial involvemet at a point where excision is to be made. The stumps of bronchi, when bronchograms show indentation in bronchial walls, have a high incidence of fistulization. Fistula developed in 88.9 per cent of the cases where there was indentation in the bronchial wall which continued far into the periphery of the bronchus. When preoperative bronchograms reveal continuous indentation in the bronchial walls at the point where excision is to be made, excision might better be made in other points or the operation postponed until there are improvements in bronchial involvement, so that fistulization might be prevented from occurring.
- 千葉大学の論文
- 1959-09-28
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- 肺結核に於ける気管支造影像の臨床的研究 : 特に気管支瘻の発生原因について