论文部分内容阅读
目的：为探讨呼吸道炭末沉着症的临床特点，以及大气污染与呼吸道炭末沉着形成的关系。方法：对因各种呼吸道症状就诊且无明显生产性粉尘接触史的２ ４９２ 人进行了胸部Ｘ 线及纤支镜检查，发现气道炭末斑者行活检或刷检，并行光镜检查。部分测定了肺功能和动脉血气。结果：经纤支镜及组织学证实呼吸道炭末沉着症１５３ 例。其中以右肺、尤其是右中叶病变居多。除炭末斑外，还可见管腔狭窄、闭塞，肉芽肿形成及粘膜充血、肥厚、肿胀等改变。部分病例可见核异质细胞，鳞状上皮化生和炎性坏死；少数合并支气管肺癌或支气管结核。进行了肺功能测定的３８ 例中，３ 例显示异常，其中１８ 例ＦＥＶ１／ＦＶＣ＜ ７０％ ；１７ 例ＭＶＶ／Ｐ＜ ７９％ 。血气分析值均正常。结论：非生产性粉尘污染所致的呼吸道炭末沉着，其主要原因为取暖设备和炉灶等所造成的室内外粉尘污染，烹调中的油烟污染是另一重要因素，炭末斑的形成与室内污染的严重程度和吸入时间长短有关。除污染因素外，患者自身呼吸道的结核和感染等损伤可能是炭末沉着的病理基础。炭末斑可以引起一系列并发症，影响患者的通气功能，目前尚无有效的治疗措施，主要应从预防入手。预防呼吸道感染，改善寒冷地区的取暖设备，改善室内空气流通，降低?
Objective: To investigate the clinical features of respiratory charcoal and the relationship between air pollution and charcoal formation in the respiratory tract. Methods: A total of 2 492 people with various respiratory symptoms who had no history of productive dust exposure were examined by X-ray and bronchofiberscopy. The airway charcoal spot was examined by biopsy or brushing and parallel light microscopy. Part of the determination of pulmonary function and arterial blood gas. Results: 153 cases of respiratory charcoal confirmed by fiberoptic bronchoscopy and histology. Among them, the right lung, especially the right middle lobe mostly. In addition to carbon powder spots, but also visible stenosis, occlusion, granuloma formation and mucosal hyperemia, hypertrophy, swelling and other changes. Some cases showed nuclear heterogeneous cells, squamous metaplasia and inflammatory necrosis; a few with bronchial lung cancer or bronchial tuberculosis. Of the 38 patients who underwent lung function tests, 3 showed abnormalities, of which 18 were FEV1 / FVC <70% and 17 were MVV / P <79%. Blood gas analysis values were normal. Conclusion: Respiratory carbon deposition caused by non-productive dust pollution is mainly due to indoor and outdoor dust pollution caused by heating equipment and stoves, and soot pollution in cooking is another important factor. The formation of charcoal spots and the indoor The severity of the contamination is related to the duration of inhalation. In addition to contamination factors, tuberculosis and infection in the patient’s own respiratory tract may be the pathological basis of carbon deposition. Carbon dust spots can cause a series of complications affecting the patient’s ventilation function, there is no effective treatment, mainly from prevention. Prevention of respiratory infections, improve the heating equipment in cold areas, improve indoor air circulation, reduce?