尿路結核知見補遺 第1篇:尿路結核の臨床統計,特にその化学療法による変貌について

Abstract

During a 6 year period (1952-1957) 11634 patients were treated at our clinic. The patients of urinary tuberculosis were 751 (6.5%) except the postoperative cases, and a nephrectomy was performed in 332 caases, a partial nephrectomy in 6 cases and a heminephrectomy in one case. On these 339 surgically treated cases, statistical observations were done. Comparing this result with the former reports in Japan, the alteration of clinical aspect in urinary tuberculosis which was caused by the antituberculous chemotherapy, was clarified statistically by this report. 1. Sex. There were 185 (54.6%) men a n d 154 (45.4%) women. 2. Age. Thirty eight per cent of the patients are in t h e priod between 20-29 years and 33 per cent are between 30-39 years. This age distribution has changed recently. 3. Incidence. The incidence of urinary tuberculosis and the case of nephre c tomy are decreasing every year. 4. About a ha l f of patients was treated internally by other physicians prior to their consulting our clinic. 5. Associated skeletal tuberculosis. Active tuberculosis was present in 9 (2.736) of the patients. About 137 rentgenologically examind cases, the lung was free of tuberculosis in 35 (25.5%) cases and the active pulmonary tuberculosis was seen in 33 (24.1%) cases. The incidence of associated active tuberculosis has decreased. 6. Tuberculous epididymitis. Tuberculous epididy m itis was present in 59 (31.9% of men) cases. This disease has increased a little in number. 7. Chief Complaint. An atypical chief complaint was encountered frequently. The patients who had not complained of any symptom referable to the vesical tuderculosis were present in 81 (23.9%) cases. And these cases has increased these few years. 8. Duration of symptoms. The interval between the onset of symptoms an d consulting our clinic varied from 1 month to several years. About a half of the patients visited our clinic within 6 months. This interval was prolonged by chemotherapy. 9. Urine. No cloudiness of urine was seen in 24 (7.1%) cases. Albuminuria was not present in 15 (4.4%) cases. These cases have increased. 10. Operated side. Right was in 163 cases an d left in 176 cases. Thirty eight of these cases had the bilateral lesion. A small renal lesion was treated medically. 11. Three hundred and thirty cases were examined cystoscopically, a n d typical vesical tuberculosis could not be recognized in 70 cases. These cases have increased. 12. From the results of many other statistical studies, it was revealed that INAH and its derivatives are better than streptmycin in the beginning of treatment, because SM has such disadvantage as promoting ureteral stricture and contracted bladder.