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目的探讨农民石工肺患者的临床特征及气管镜下表现。方法分析2012-03/2015-07期间入住达州市中心医院的农民石工和煤矿工患者的胸部CT检查和支气管镜检查结果及临床资料。结果共计133例农民石工及煤矿工患者,全部系男性,年龄30~80岁,平均年龄60.55岁,其中农民石工71例,从事采煤的农民或矿工62例,农民石工患者的平均年龄较煤矿工患者小4.68岁,两组患者胸部CT改变除弥漫小结节外,其余观察项差异无统计学意义(P>0.05),农民石工患者气管镜下发现新生物30例(42.25%),明显多于煤矿工患者(13例,20.97%,P<0.05)。农民石工患者气管变形狭窄及痰末沉着的例数少于煤矿工患者(P<0.05)。农民石工患者胸部CT符合矽肺改变者占53.52%,与煤矿工尘肺(64.52%)相比无显著差异(P>0.05)。综合病史、胸部CT改变和气管镜检等资料,农民石工患者诊断肺癌的比例(38.03%)高于煤矿工患者(19.35%)(P<0.05),而煤矿工患者的慢性阻塞性肺疾病发生率(45.15%)显著高于农民石工患者(21.13%)(P<0.05)。结论农民石工发生尘肺和肺结核的比率与煤矿工差异无统计学意义,而农民石工患者的肺癌发生率高于煤工患者,煤矿工患慢阻肺者多于农民石工,二者气管镜下的表现各有特点。农民石工气道内易见新生物,而煤矿工患者气道内碳末沉着及气道狭窄多见,这些差异可能与不同粉尘原致病机理不同有关。
Objective To investigate the clinical characteristics and bronchoscopic features of peanut lung workers. Methods The chest CT and bronchoscopy results and clinical data of the peasant mason and coal miners who lived in Dazhou Central Hospital between March 2012 and July 2015 were analyzed. Results A total of 133 peasant mason workers and coal miners were male, aged from 30 to 80 years, with an average age of 60.55 years. Among them, 71 were peasant masonry, 62 were peasants or miners engaged in coal mining. The average age of peasant mason workers was higher than that of coal mines Workers in the hospital were 4.68 years old. There was no significant difference in CT findings between the two groups (P> 0.05) except for diffuse small nodules. 30 (42.25%) newborns were found under tracheoscope in peanut masonry workers More than miners (13 cases, 20.97%, P <0.05). Peasant workers masonry tracheal deformation narrow and sputum sedimentation less than the number of cases of miners (P <0.05). There was no significant difference (P> 0.05) between the chest CT of the mason workers and the pneumoconiosis of coal miners (53.52%, 64.52%). Comprehensive medical history, chest CT changes and bronchoscopy and other data, the proportion of peanut stone workers diagnosed with lung cancer (38.03%) was higher than that of coal miners (19.35%) (P <0.05), while the chronic obstructive pulmonary disease The rate (45.15%) was significantly higher than that of peasant mason workers (21.13%) (P <0.05). Conclusion There is no significant difference between the rate of pneumoconiosis and tuberculosis among peasant workers and that of coal miners, while the incidence of lung cancer among peasant workers is higher than that of coal workers. Each has its own characteristics. Farmers masonry airway easy to see new organisms, and coal miners in the airway carbon deposition and airway stenosis more common, these differences may be related to the different pathogenesis of different dust.