尿路結核に対する保存的手術症例の検討

Abstract

Conservative operations were performed on 63 cas e s of renal tuberculosis in our clinic. The cases were divided into two groups. The group A, consisted of 29 cases, was operated on renal lesions, and the group B, consisted of 34 cases, was given operative treatment to the obstructive lesion of the upper urinary tract. All the patients were examined during both of pre- and post-operative courses with references to PSP excretion, serum NPN and electrolytes as well as postoperative complications and prognosis. The results are sum merized as follows : 1. PSP excretion test : In the majority of the cases of Group A, a decrease in PSP excretion was noted in both pre- and postoperative periods, while such decrease was seen in only a few cases of Group B. 2. Serum NPN : In many cases of Group A, the serum NPN increased during 3 to 7 days after the operation. In Group B, almost all cases showed a elevated NPN leveel thoughout the pre- and postoperative courses, though some improvement was noted by the time of discharge. 3. Ser um electrolytes : In the group A, serum potassium level showed a tendency of increase during 3 to 7 days and 2 to 3 weeks after the operation. High levels of serum sodium and chlorine seen in the preoperative period returned toward normal in the postoperative period. In many cases of Group B, marked fluctuations in serum potassium level were noted both in the pre- and postoperative periods. High levels of serum sodium and chlorine observed in the preoperative period sustained at similar levels in the postoperative period too. In both pre- and postoperative periods hyperchloremia was seen in more cases than in Group A. 4. Postoperative complica tions : During the postoperative period, pyelonephritis occurred in 21 % in Group A and in 35 % in Group B. Four cases died of postoperative complications during hospitalization, 5. Postoperative follow-up : Fourty-five cases are now in good health, 11 cases have some subjective complaints and 3 cases died after the discharge.