レイノー氏病に対する定位的蒼球手術—指尖容積脈波学的研究

STEREOTAXIC PALLIDOTOMY FOR RAYNAUD'S DISEASE : PLETHYSMOGRAPHIC STUDY

緒言

　レイノー氏病は1862年にMaurice Raynaudによつて，最初に記載された疾患である。本疾患の主要な症状は四肢末端の対称性におこる発作性循環障害によつて，進行性に壊死におちいる湿性脱疽とされている。

　この疾患の誘因となるものは，いくつかのものが認められているにもかかわらず，発生原因についてはいまだ定説をみない。ただ仮説として一般に認められていることは，血管壁の攣縮とか，交感神経節の器質的障害によるところの血管運動神経の病的興奮などである。

As general experiences, the streotaxic pallidotomy is proved effective for the hy-pertonic state of rigidity-type in Parkinson-ism very dramatically and sometimes to its vegetative symptoms, such as hypersaliva-tion, hyperhydrosis or seborrhoea of faces.

The authors tried to measure the change of peripheral capillary state by photoelectric plethysmography during the pallidotomy. In 29 cases of Parkinsonism and of athetosis, plethysmographic amplitude was increased to twice or three times than preoperative, suggesting that the capillary walls being dilatated by operation.

Based on this findings, one case of Ray-naud's disease was operated with marked success. The patient, female, 47 years old, has shown the necrotizing process and se-vere pain of the contralateral middle-fingers to the side of operation, and these symptoms are completely diminished within twelve hours after pallidotomy. After lasting two winters, she is quite well with no side effects, working in house keeping duty, such as washing and cooking.