Studies on the Short Term Hospitalization of Patients with Pulmonary Tuberculosis. (The Second Report).
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In the first report, the authors compared the results of chemotherapy in the short term hospitalization group with that in long term hospitalization group and the ambulatory group, and recommended to start chemotherapy under short term hospitalization, if the long term hospitalization was impossible. The authors continued studies on the same problem, and the results were presented in this report. The number of cases was increased, and the observation period was extended to two years after starting treatment.<BR>A total of 692 patients with pulmonary tuberculosis who were detected by the mass survey and had no previous history of chemotherapy were subjected to the study. Of these patients, 345 were hospitalized for various period, and they were divided into 3 groups according to the term of hospitalization; namely, 92 were hospitalized for 3 months (short term), 136 for 6-8 months (semi-long term) and 117 for 9 months and over (long term). Remaining 347 cases were treated at out-patient clinic and continued to work. Among them, 213 received regular treatment, 71 received irregular treatment and 63 dropped on the way of treatment. The results of treatment were evaluated by the course of radiological findings during treatment, and the results were the following.<BR>1) Evaluated at 2 years after starting chemotherapy, as shown in Fig. 1, the rate of cases showed radiological improvement in the hospitalization groups was clearly superior to that in the ambulatory groups, but, no significant difference was observed in the rate of radiological improvement among the long term, semi-long term and short term hospitalization groups. The rate of significant radiological improvement was highest in the long term hospitalization group. No significant difference was found in the frequency of radiological deterioration during 2 years among the hospitalization groups and the ambulatory groups.<BR>2) Comparing the rate of radiological improvement in cases with exudative or infiltrative-caseous type lesions treated by the triple combination of SM, INH and PAS, as shown in Fig. 3, the results of ambulatory group was nearly equal to that of the hospitalization groups, if ambulatory treatment was conducted regularly.<BR>3) Among the ambulatory group, 20% received treatment irregularly and 18% dropped on the way of treatment. Among the hospitalization group, chemotherapy was continued at out-patient clinic after discharging from the hospital, and of these cases, 12% received treatment irregularly and none dropped on the way of treatment. The results of chemotherapy evaluated by the rate of radiological improvement and deterioration in the irregular ambulatory group was inferior to that in the short term hospitalization group. These facts indicate the difference in the results of chemotherapy between the hospitalization and ambulatory groups.<BR>From the results of the study mentioned above, it can be concluded as follows: it is advisable to start chemotherapy under hospitalization for all tuberculous patients newly detected by the mass survey, and if long term hospitalization is impossible, short term hospitalization followed by chemotherapy at out-patient clinic is recommended to improve the results of treatment.
- 一般社団法人 日本結核病学会の論文
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関連論文
- Studies on the Short Term Hospitalization of Patients with Pulmonary Tuberculosis. (The Second Report).
- Studies on the Short Term Hospitalization of Patients with Pulmonary Tuberculosis.