| The clinical Study of Prognosis of Pulmonary Tuberculosis Cavities Treated Non-Surgically and Cavitary Pulmonary Tuberculosis Patients |
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Taik Chae Kim |
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SEA VIEW Hospital, New York City, USA |
| 비외과적 요법하의 폐결핵공동급 공동성결핵환자의 예후에 관한 임상적 연구 |
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김택제 |
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| Abstract |
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Evaluating and analyzing 274 cases of cavitary pulmonary tuberculosis patients treated nonsurgically, 430 cavities were found roentgenologically among these patients, the following findings are presented :
1. The incidence of cavity closure and of sputum conversion to negative were 62.9 per cent and 85.8 per cent respectively. 2. The incidence of cavity closure was not influenced by sex of patients, but wa s inversely proportionate to the age of the patients. There was neither difference in the ratc of cavity closure between the left and right lung, nor by lung fields (upper, middle, or lower third). However, centrally located cavities closed more frequently than those located peripherally Cavities which had triangular or polygonal appearance were not closed favorably comparing with those cavities of round or oval appearance. Cavities sized three centimeters or less in their diameter had closed very favorably without showing any difference in closure rates by size. However, the in cidence of closure of cavites over three centimeters in diameter was quite low and was inversely proportionate to their size.
The incidcnce of cavity closure was inversely proportionate to the thickness of cavity wall. Single cavities closed much more favorably than multiple cavities. However, the rate of closure of individual multiple isolated cavities was not worse than that of single cavities. The pericavitary infiltrations of moderate and/or less degree were not harmful to cavity closure, but those of marked degree were. The pericavitary fibrosis had an appreciable influence on cavity closure; i .e. , the more fibrosis existed, the poorer the rate of cavity closure.
Contralateral Iung disease of slight and/ or Iess in its degree did not hamper the closure of cavities, but that of moderate and/or more degree definitely did. The age of cavities was sharply related to the rate of cavity closure; i.e., the cavities less than a year of age ially less than six months old. had closed very- but those of over year had closed with very low incidence. The incidence of cavity closure was higher in the group treated with chemotherapy and temporary collapse procedures than in those treated with chemotherapy alone.
The cavities that were receiving initial treatment had closed very favorably, but those receiving re-treatment did poorly.
3. About one half of the closed cavities were closed within six months of treatment, and most of them were closed by nine months.
4. About one half of the converted cases were converted to negative bacteriologically within three months of treatment and most of them became negative within six months.
5. In a great majority of cases bacteriological negativity had been followed by cavities closure. About 60 per cent of closed cavities were closed with-in three or four months after sputum conversion on to negative and most of them were closed by six months.
6. The incidence of open negative cavity was 21. 2 per cent. There was no difference in the incidence between-
and multiple and multiple cavities.
7. The average duration of hospitalization of cavitary pulmonary tuberculosis patients was 12.9 months in single cavitary groups, 16.0 months in uni-lateral multiple cavitary groups, and 20.2 months in bilateral multiple cavitary groups.
8. The mortality of cavitary pulmonary tuberculosis patients was in direct proportion to the extent of the disease, multiplicity of cavities, and age of patients. Deaths due to pulmonary tuberculosis were 6.2 per cent, and 1. 4 per cent died of massive pulmonary hemorrhage. |
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