"extraperiosteal fluid plombage thoracoplasty" (近中法) により呼吸器能改善が得られ, 換気血流シンチで評価した結核性有瘻性全膿胸の一例

概要

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A 66-year-old man had had artifical pneumothorax at 28 years of age as a treatment for left tuberculosis, developed marked dyspnea due to left tuberculous empyema. The severity was a grade VI in the H-J Classification. He subsequently underwent treatment extraperiosteal fluid plombage thoracoplasty by the "Kinchu method". His dyspnea improved to grade II in the H-J Classification within four months after the operation, and an X-ray film revealed aeration in the left lung. The %VC improved from 37% to 57%, and the forced one second expiratory volume (FEV1.0) also improved from 0.62l to 1.09 l. Perfusion lung scans showed that left lung prfusion volume increased from 60 ml to 150 ml. Therefore, it was considered that 690 ml (88. 5 %) of the 780 ml increase in FVC was due to an incease in volume of the right lung. Athough postoperative increase in the rate of ventilation was observed in the left lung, an iprovement of blood flow was not demonstrated by ventilation-perfusion scintigraphy.