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아메바性 肝膿瘍에 關한 臨床的 硏究

A Clinical Study of Amebic Liver Abscess

경북의대잡지 1976년 17권 1호 p.56 ~ 75
최호섭, 鄭克守,
소속 상세정보
최호섭 (  ) - 慶北大學校 醫科大學 內科學敎室
鄭克守 (  ) - 慶北大學校 醫科大學 內科學敎室

Abstract


Four hundred and seventy-four cases of amebic liver abscess admitted to the three major general hospitals i.n Daegu City, Korea (Kyungpook National University Hospital, Dongsan Presbyterian Hospital and Fatima Hospital) during the past 15 years frorn 1961 to 1975 were surveyed on various clinical aspects. In addition, serial hepatoscans with 198Au 1`or 44 cases were done in an attempt to determine the resolution time for the amebic liver abscesses by different modality of treatment.
Group A(total 25 cases) was treated with chloroquine or~rlly 1, 0 gm on day 1 and 2 and 0.5 gm daily thereafter for 19 days along with oxytetracycline 2.0 gm per day in 4 divided doses for ´_0 days. while group B(total 19 cases) was treated with additional nitroimidazole derivatives(metr~-nidaz~le 1, S00 mg per day in 3 divided doses for 5-10 days or tinidazole 600mg .per day in 4 divided doses for 5-10 days). Emetin hydrochloride was seldom u;~ed except for severe cases (0.065 gm parenterally for 5-7 days). Needle aspirations of pus were routinely combined with the above medication.
The size of the abscess was measured on scan film and was grouped into 3 graded sizes i, e large over 15 cm in diameter), moderate (10-i5 cm in diarr.~eter) and small (less than 10 cm in diameter).
The results obtained were as follows:
1. About 60% of cases belonged t~ the age groups of 4th and 5th decades and male to female ratio ~tivas 5.8:1. Residents in rural districts were greater in number by 2.2 times of urban residents.
The yearly .incidence of cases among total in-patients of department of Internal Medicine and General Surgery has decreased recently from around 0.7% clown to 0.4%.
2. Biliary tract disease was the iniial diagnosis of 11.4 %and hepatma 6.1%.
3. Mean days for the body temperature begin to fall and return to normal were 4.8 and 7.5 days respectively. And drop in fever was faster in smaller size group .but did not show significant difference in rapidity between group A and B.
4. Prognesis was improved sitige 1970 when liver scan and nitroimidazole derivatives were available. And prognosis of group B was better than that of group A both treated during the sam:; period ci~1970-1975.
5. Healing of abscess was seen after 4 weeks of ,treatment and numbers of healed cases vrere greater. ink~group. B. However, the rate of reduction in sizf; of abscess during the 4 weeks after the ` iritiatori of treatment- showed no difference between group A and B and also it had poor correlta thy the grading of abscess size.

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