菌陰性空洞の臨床的観察 予後に影響する因子の検討

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概要

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• There were 129 cases which were defined as open-negative among 3037 patients of pulmonary tuberculosis who had entered the author's sanatorium during the 6 years' period from April 1959 to April 1965.<BR>Open-nagative cases were defined as follows: during the observation period for 6 months andover, the monthly bacteriological examination revealed consecutively negative results, and cavity remained while being treated only by chemotherapy.<BR>The open-negative cases occupied 4.2 % of the whole cases or 7.2% of those with cavity. The duration of observation period on these 129 cases was, on the average, 18 months (rangingfrom 3 months to 6.5 years) after they reached to the open-negative status.<BR>The aim of this study was to clarify the factors influencing the p r ognosis of these opennegative cases according to the radiological and bacteriological aggravation. As the nature of cavity was considered to be the most important factors, analysis was made on the aggravation rate by the thickness of cavity wall and other conditions of cavity wall.<BR>The aggravation rate among cases with multiple cavity was 47.1%, which was much_higher than the rate among cases with single cavity (14.7%). Regarding the thickness of cavity wall, as it was expected, there was no aggravated cases in Group I with thin walled cavity. But, the aggravation rate was rather high in Group IV with the thick walled cavity, as well as in Group II with partly thicker cavity wall. (Tables 4 and 5)<BR>The duration of the bacilli negative status was also a noteworthy fa c tor. Almost all of the aggravation (13 out of 14 single cavity cases, and 14 out of 16 multiple cavity cases) occurred within 12 months after reaching to the open-negative status. (Tables 4 and 5)<BR>The prognosis of the cases converted to negative in a shorter period after starting chemotherapy was better than that of the cases required longer period for negative conversion. (Fig.3)<BR>The relation between the prognosis and other factors, namely, the nature of cavity at the beginning of treatment, the changes of cavity size during the treatment, and the size of cavity when the open-negative status was revealed, was not clear.<BR>As the duration of the observation period after the cessation of chemotherapy was short, the majority of aggravation occurred during chemotherapy. The most of the aggravated cases were cured by chemotherapy, and the serious aggravation was observed in only 3 cases.

• 一般社団法人 日本結核病学会の論文

著者

• 佐藤 瑞枝

  結核予防会結核研究所

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