CLINICAL ANALYSIS OF PATIENTS WITH SEQUELAE OF PULMONARY TUBERCULOSIS UNDERGOING HOME OXYGEN THERAPY

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  • IWANAGA Tomoaki
    Department of P1ulmonary Medicine, National Hospital Organization (NHO) Fukuoka-Higashi Medical Center
  • IKEDA Togo
    Department of Pulmonary Medicine, National M 2inamiFukuoka Hospital (at present; Moji Municipal Hospital)
  • MACHIDA Kazuko
    Department of Pulmonary Medicine, NHO Tok y3o National Hospital, `Department of Pulmonary Medicine, NHO Higashisaitama National Hospital
  • KAWASHIRO Takeo
    Surgical interventions of pulmonary tuberculosis

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  • 在宅酸素療法を施行した肺結核後遺症症例の臨床的解析
  • ザイタク サンソ リョウホウ オ シコウ シタ ハイケッカク コウイショウ ショウレイ ノ リンショウテキ カイセキ

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[Purpose] To clarify the clinical characteristics of patients with sequelae of pulmonary tuberculosis undergoing home oxygen therapy.<BR>[Objects an d Methods] We conducted a cross-sectional survey of those with newly-introduced home oxygen therapy for the sequelae of pulmonary tuberculosis from 1998 through 2001, using national hospital network of respiratory dis eases.<BR>[Results] The study subjects were 402 in total (271 men and 131 women), who started the home oxygen therapy at the age ranging between 33 and 100 years (72. 2 ± 8. 1 years, mean ± S. D. ). They suffered from pulmonary tuberculosis at the mean age of 37. 7 ± 19. 4 years, and the interval leading to oxygen therapy averaged 33. 1 ± 19. 1 years. Sixty-eight percent of these patients demonstrated body mass index (BMI) less than 20. Pulmonary function studies revealed the markedlydecreased vital capacity (46. 2 ± 15. 0%) as well as reduced FEV1/FVC (68. 5 ± 18. 8%). Arterial blood gases m easured when home oxygen therapy was introduced showed hypoxemia (Pa02, 60. 4 ± 10. 7 Torr. ) with hypercapnea (PaCO2, 50. 5 ± 9. 4 Torr). The average flow rate of oxygen was 0. 94 ± 0. 64 L/m in at rest and 1. 51 ± 0. 70 L/min on exertion.<BR>The patients were divided i nto two groups; those with surgical intervention including thoracoplasty or lung resection (126 cases, group 1) and those without surgery (148 cases, group 2). The mean age of the patients in the group 1 when home oxygen therapy was started was 72. 3 ± 6. 4 years and 71. 6 ± 9. 1 years in the group 2, respectively. Subjects in group 1 were more likely suffered from TB in younger age than those in group 2 (28. 2 ± 9. 7 vs. 45. 4± 21. 5 years, p< 0. 01), and had the longer duration to initiate domiciliary oxygen therapy (43. 0 ± 10. 9 vs. 25. 3 ± 20.3 years, p< 0.01). The former was also more likely to have lower %VC (p< 0. 01), more elevated PaCO2 (p< 0. 05), and lower inspired flow rate of oxygen (p< 0. 01). There was no significant difference between the two groups with respect to BMI, FEV1/FVC, or PaO2.<BR>[Conclusion] Our investigation demonstrated that patients with sequelae of pulmonary tuberculosis under oxygen therapy revealed the different clinical course and characteristics regarding the presence or absence of previous surgical intervention.

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