重症肺結核の外科療法に関する研究 第1編 心肺機能検査成績について

Chemotherapy and surgical therapy have made such tremendous strides against pulmonary tuberculosis that it has been reduced to a disease which can be managed with much less difficulty than before. However, a group of severe cases which is very difficult to be cured or improved still remains, requiring prompt establishment of the approved treatment of choice from the social, economical and medical poinc of view. In an attempt to achieve better cure or improvement for these cases through surgical intervention, the author picked out the so-called surgical far advanced cases from them, and classified these into 7 types (A-G) from the X-Ray findings of lesions and other states of chest and took their cardiopulmonary function into consideration. The restlst are given below. In these so-called surgical for advanced cases ef pulmonary tuberculosis, marked functional impairment is noted both in ventilation and circulation, although differences exist more or less among them. The impairment is generally represented by the decrease of pnlmonary ventilation and increase of pulmonary arterial pressure. The degree of functional impairment corresponds to the extent of parenchymal damage of the lung and is also infuluenced remarkably by pleural callosity and surgical collapse therapy. The decline in vital capacity is closely related to the increase of pulmonary arterial mean pressure, which frequently exceeds 20 mmHg especially when the percent-vital capacity is below 60. The limit os functional compensation can be detected by loading the patient 10% low oxygen and in cases with oxygen saturation of peripheral arterial blood (Sao(2)) less than 60% there occurred right heart failure not infrequently.