폐결핵에 대한 골막외 파라핀 충전술

Extraperiosteal Paraffine Plombage Thoracoplasty for Pulmonary Tuberculosis

중증 공동성 폐결핵환자에 대해 파라핀을 사용한 골막외 충전술을 1973년부터 시행한 후 관찰된 1,003명에 대한 결과 및 그 수술방법을 살펴보았다. Plomb의 감염유출을 일으킨 예는 78명 이고 모두 plomb 제거후에는 별다른 이상이 나타나질 않았다. EPPT로서 3cm 이하의 공동을 가진 결핵환자는 90%, 5cm 이상의 거대공동 환자는 40%에서 치유되었으니 EPPT가 우리나라의 결핵 문제 해결에 도움이 될 것임을 확신하는 바이다.

Background: From 1973 we performed EPPT for the 3,500 cases of the cavitary tuberculosis who were not responded well to the antimicrobial drugs, and we evaluated the 1,003 cases who could be followed up to more than 3 years postoperatively. Method: The key of the EPPT was that the 5-8 ribs of unilateral chest were denuded at the one stage operation and the paraffine was used as the plomb of filling the dead space out of the collapsed periosteums and intercostal muscles. Result and Conclusion: Number of patients who had unilateral EPPT was 759 and bilateral 244. The late complication were subscapular abscess (12) lump formation (42) and paraffine expectoration (26). All of those complications was cured after removal of the packed paraffine. Sputum conversion rates were 91.6% in the group with cavity less than 3 cm and 41.8% in the group with cavity bigger than 5cm.