肺結核悪化患者の発見 : 患者管理の立場から

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150 patients, who were diagnosed as showing aggravation of pulmonary tuberculosis and admitted to our hospital during the period from March, 1972 to February, 1973 (Table 1), were studied in order to analyze the correlation between the grade of aggravation and the following clinical symptoms: *cough and sputum continuing for more than 2 weeks *bloody sputum or hemoptysis *fever over 38.0°C continuing for more than 3 days *chest pain *evident emaciation The results were as follows: 1) Among 112 cases showing aggravation with a large amount of bacilli discharge and with worsening of chest X-ray findings, cough was found in 80%, sputum in 77.7%, bloody sputum or hemoptysis in 33.3%, fever in 42.0%, chest pain in 25.9%, and emaciation in 72.3% (Table 2). 2) Among 27 cases showing a small amount of bacilli on culture (less than 20 colonies) with worsening of chest X-ray findings, the above symptoms were found in 33.3%, 33.3%, 40.7%, 33.3%, 25.9% and 29.7%, respectively (Table2). 3) No symptom was observed in 11 cases showing smear positive-culture negative bacilli or single isolation of positive bacilli on culture (less than 20 colonies) without radiological worsening except one complicated with bronchial asthma (Table2). 4) Out of 62 cases who live in Osaka Prefecture, 40 had been registered as tuberculosis at some of health centers in Osaka Prefecture. Among these 40 cases, 30 were treated irregularly or defaulted from treatment and the remaining 7 were inactive cases under followup (Table3). 5) Over 85% of aggravated cases in this study were discovered by symptomatic visit to general practitioners (Table 3). From the standpoint of patients-supervision, it can be said that more emphasis should be given to prevent patients from defaulting during treatment and to recommend symptomatic visit to physicians for inactive cases.
日本結核病学会の論文

肺結核悪化患者の発見 : 患者管理の立場から

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