| A Study on Chronic Far Advanced Pulmonary Tuberculosis Patients |
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Chan Sae Lee, Yie Yoon Kim |
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Pusan City Branch Clinic Korean National Tuberculosis Association |
| 만성중증 폐결핵환자에 관한 연구 |
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이찬세, 김의윤 |
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| Abstract |
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The cases of chronic far advanced pulmonary tuberculosis patients that were on-going out-patients at Pusan City Branch clinic of Korean National Tuberculosis Association during last one year from Oct. 1985 to Sept. 1986 have been studied on several aspects by direct inquire and follow-up examination. Total number of the patients were 134 cases, male 81 and female 53. Among them 70.90% were sputum positive on smears and cultures at the beginning. The results were as follows;
1) Sex and age_ As usual sex distribution of pulmonary tuberculosis patients in this country, there were more chronic far advanced patients among males than females by ration of 3: 2 aproximately. However, the peak age group was somewhat younger among females as of 31-50 years old to 41-60 on males.
The incidence showed definite decline after 60 years old age group in both sexes. This was interpreted as a peculiar phenomen of old age group conserγatism of direct or indirect since the national survey showed that the incidence was gradually increasing towards old age rather than decreasing at those age groups.
2) Modes of onset or motives of diagnosis and initial treatment and patient’s life circumstamces_ The majority patients showed that the onset was incidious (79 .85%) and the initial treatments were irregular or even payed veη little attention at all (82.09% together) Their lifes were very poor or poor in 82.84% and the patients themselves were sole supporters of their famillies which made their treatments more difficult.
3) Drug sensitivity and results of treatment at our clinic.
Because of the cost of sensitivity test for drugs were expansive for many of these patients only 78 tests were done in 45 patients. Instead of their previous irregular treatments of several years, 20% of them showed sensitivities for 3 different oral drugs, although the selection of drug regimens in general were not easy tasks in those patients. The overall results of treatment for more than 2 years at this clinic were very poor, showing only 2.11 % (2 patients) of sputum negative conversion with no marked improvement on x-ray pictures.
4) Our reasonable recommendations of the treatment for those patients with due consideration of their present clinical status and their poor circumstances would be roughly classed in 3 categories:
a. 7.46% of them could have surgery better.
b. 54 .48% of them should be treated in hospital for the purpose of isolation and terminal care.
c. Remaning 38.06% could be continuously treated at out-patients clinic.
5) In conclusion, the authors believe that an active measure absolutely necessary to improve tuberculosis control in our country would be to have the chronic far advanced pulmonary tuberculosis be treated by hospitalization for isolation of major sources of disease transmissions and also for terminal cares. |
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