Tuberculosis and Respiratory Diseases
- 제43권4호
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- Pages.491-499
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- 1996
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- 1738-3536(pISSN)
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- 2005-6184(eISSN)
결핵성 흉막염 환자에서 흉수가 폐기능에 미치는 영향에 대한 연구
A Study of Effect on Pulmonary Function of Pleural Effusion in Tuberculous pleurisy patients
- 임정윤 (이화여자대학교 의과대학 내과학 교실) ;
- 이기현 (이화여자대학교 의과대학 내과학 교실) ;
- 정혜경 (이화여자대학교 의과대학 내과학 교실) ;
- 장중현 (이화여자대학교 의과대학 내과학 교실) ;
- 천선희 (이화여자대학교 의과대학 내과학 교실)
- Yim, Jeong Yoon (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
- Lee, Kee Hyun (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
- Jung, Hye Kyung (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
- Chang, Jung Hyun (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
- Cheon, Seon Hee (Department of Internal Medicine, Ewha Womans University College of Medicine)
- 발행 : 1996.08.30
초록
연구배경 : 흉막염은 임상에서 흔히 접하게 되는 질환이나 폐기능에 미치는 영향 및 천자 후 변화는 많이 연구되어져 있지 않다. 이전의 보고들은 흉막 천자 후 폐기능 변화와 동맥혈 산소 분압은 거의 없거나 작은 호전을 보인다고 보고하였다. 이에 흉막액이 폐기능에 미치는 영향, 흉막천자 후 폐기능 및 동맥혈 간소 분압의 개선 정도와 장기 경과 관찰후 폐기능의 변화를 살펴보고자 하였다. 방법 : 1994년 2월부터 1995년 9월까지 이화여대부속병원에 결핵성 흉막염으로 입원한 환자 27명을 대상으로 하여 흉막액의 경중도와 발현되는 증상, 증상 발현 기간에 따라 폐기능을 비교하고 천자 전후의 변화를 측정하였다. 결과 : 1. 흉막염은 제한성 폐기능 장애를 야기시키며 소기도 뿐 아니라 대기도의 기능 장애도 유발시킨다. 2. 흉막 천자후 MMFR,
Background : Pleural effusion is a common disease in clinical practice but its effect on pulmonary function and altered pulmonary mechanics after removal of effusion are not still largely understood. Previous studies have shown that there is little or a relatively small improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracentesis. The present study was designed to assess the effect on pulmonary function of pleural effusion and to test whether there was a significant improvement in pulmonary function and arterial oxygenation after thoracentesis and to observe long tenn effect after thoracentesis. Method : We examined flow-volume curve, body box and arterial blood gas analysis according to severity of effusion, present symptom, and symptom duration. Then, we measured changes of pulmonary function after thoracentesis and observed longterm effect after thoracentesis. Result: 1) Pleural effusion cause restrictive pulmonary insufficiency. Not only functional impairment of small airway but also large airway is provoked. 2) MMFR, FEV1, Raw, POz are earlier improved than FVC and TLC after thoracentesis and patients without complication have mild restrictive pulmonary insufficiency after longterm observation. 3) FVC, FEV1, & TLC are similarly restricted as severity of pleural effusion and po, is relatively decreased. 4) Cases with symptom duration 1 week or less and cases with dyspnea have more severe pulmonary insufficiency than others. 5) The flow volume curves show a relatively greater improvement in flow rates at large lung volumes than small airway. 6) Significant relationship is shown between first thoracentesis amount and changes of FEV1, FVC, TLC. Conclusion: Pleural effusion cause restrictive pulmonary insufficiency and not only functional impairment of small airway impairment but also large airway is provoked. Then, Pulmonary function is progressively improved after thoracentesis and remained mild restrictive pulmonary insufficiency after recovery.