Basal plombage.
نویسندگان
چکیده
The treatment of tuberculous cavities in the lower lobe is difficult. Simple measures such as phrenic paralysis with or without pneumoperitoneum, artificial pneumothorax, postural retention, chemotherapy and bed rest, alone or in combination, have proved effective in only two-thirds of the patients, and, even in these, relapse has been frequent. Crofton (1949), reviewing a series of 54 cases in which a tuberculous cavity in the apex of the lower lobe was the dominant lesion, reported that 66% of cases were treated successfully with artificial pneumothorax, whilst Macdonald (1952) recorded almost identical figures for cases treated by the simpler measures outlined above. It is difficult to determine the causes of failure, but it would appear that the apex of the lower lobe is difficult to relax adequately. Not only is it a relatively short, squat segment whose inward migration is hindered by the rigid hilum, but adhesions between the segment and the costo-vertebral groove are common and frequently extensive and short. Furthermore, the rise of the diaphragn produced by phrenic paralysis, even when supplemented by pneumoperitoneum, is often disappointingly limited posteriorly (though often extensive in front) so that the effect on the apex of the lower lobe is not considerable. Resection has been increasingly used either as a primary method of treatment, or more often where simpler measures have failed in patients whose disease is limited to the lower lobe. It is, however, generally regarded as inadvisable where lesions are
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عنوان ژورنال:
- Thorax
دوره 11 3 شماره
صفحات -
تاریخ انتشار 1956