当内科入院肝硬変症患者20例の臨床的観察

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20 cases of hepatic cirrhosis were admitted to our clinic in the recent 7.5 years (Apr. 1949-Sep. 1956). The present report includes the clinical statistics upon them. Typical Laënnecs cirrhosis was seen in 14 cases, alcohlic hypertrophic cirrhosis in 3 cases and each one case of cholangitic and syphilitic cirrhosis with added one case of hepato-lenticular degeneration. There were 19 males and only one female. The patients 40-60 aged were as many as 80 per cent. 3 cases had the anamnesis of previous icterus or hepatitis, 7 cases were heavy drinker. Initial symptoms were full feeling of the abdomen in 11 cases, icterus in 5 and general malaise in 3 cases. Until hospitalization, 30-50 days were passed in 6 cases after they had first perceived of the subjective symptoms, 180-300 days in 5 cases, 90-150 days in 4, 15-20 days in 2, 2 years in 1 and extraordinarily long term of 27 years in one cases of hepatolenticular degeneration. As a chief complaint when admission, abdominal full feeling was seen in 14 cases, general malaise in 2, icterus in 2 and each one case of epigastric distress and palpitation. Of physical examination, icterus was seen in 16 cases but generally not so eminent except 2 cases of severe icterus, vascular spider was seen in 11 cases, red palm in 2, edema in 11 and venous dilation of the abdominal wall was seen in 15 cases with 1 case of Caput medusae. Ascites was present in 17 cases but not detecteble in 3 cases of alcohlic cirrhosis. The liver was palpable 1 _??_ 3 finger-breadths in 5 cases of Laënecs cirrhosis, 2 _??_ 5 fingers in 3 cases of alcohlic cirrhosis and 3 fingers in one cases of cholangitic cirrhosis; all had a relatively sharp edge with nodular and firm surface. The spleen was palpated about 1 _??_ 2 finger breadths in 4 cases. Bilirubinuria was found in 8 cases, urobilinogen in the urine was elevated in 16 cases. Serum bilirubin revealed the direct prompt Hijmans van den Bergh reaction in 6 cases, its biphasic slow reaction in 3 cases, slow reaction in 3 cases; Meulengracht 70 _??_ 75 in 2 cases, 22 _??_ 36 in 5, 10 _??_ 19 in 9 and 6 _??_ 8.5 in 3 cases. Serum Takata reaction was positive in 17 of 19 cases tested and Bromsulfalein retention in 8 of 9. By the roentogenic examination, oesophogeal varices was seen in 4 cases. Serum Wassermann reaction was positive in 3 cases. 11 cases were dead during hospital day and when discharged, 2 cases were unchanged, 4 cases somwhat improved 3 cases showed a remarkable cure. Among the survived patient afterthere, 3 cases were dead, one case unchanged, one case healthy and 2 cases are now still under treatment.
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当内科入院肝硬変症患者20例の臨床的観察

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