论文部分内容阅读
目的研究黑刚玉粉尘对职业接触工人的健康危害及铝尘肺的临床特征。方法对某砂粉厂1989至2004年诊断的75例铝尘肺病例进行回顾性分析。结果75例铝尘肺病例中,Ⅰ期27例(占36.00%)、Ⅱ期28例(占37.33%)、Ⅲ期20例(占26.67%)。患者发病工龄最短3年、最长17年,10年以下工龄者有37例。铝尘肺患者胸部X射线表现主要为不规则小阴影t(2275)、s(475)、tu(175)、ts(275),或以不规则影为主的两者混合小阴影sp(575)、sr(175)、tp(975)、tq(575);少部分也可表现为圆形小阴影[p(675)、q(175)、pq(375)、qp(175)],或以圆形小阴影为主的两者混合表现[ps(1175)、qs(375)、qt(175)]。75例患者中,27例X线胸片出现大阴影,其中20例被诊断为Ⅲ期尘肺,他们的胸片可见到融合团块,部位多位于两中上肺区,单侧团块8例(占40.00%),两侧对称出现12例(占60.00%)。CT影像可见,团块由多量不规则小阴影逐渐聚集、融合而成,形态以条形或发辫形居多,具有密度不均、结构松散、边缘不整的特点。患者纵隔、肺门淋巴结普遍增大、钙化,可伴有胸膜增厚。经相关分析,患者肺功能损伤程度与铝尘肺期别无明显相关性(r=0.015,P>0.05)。结论短期、高浓度接触黑刚玉粉尘可引起严重的铝尘肺。铝尘的危害不容忽视。
Objective To study the health hazards of black corundum dust on occupationally exposed workers and the clinical features of aluminum pneumoconiosis. Methods A retrospective analysis of 75 cases of aluminum pneumoconiosis diagnosed in a sand mill from 1989 to 2004 was conducted. Results Among 75 cases of aluminum pneumoconiosis, 27 cases were stage Ⅰ (36.00%), 28 cases were stage Ⅱ (37.33%) and 20 cases were stage Ⅲ (26.67%). The shortest length of service for patients with onset of 3 years, up to 17 years, 37 years of workers under 10 years of age. The chest X-ray findings of patients with aluminum pneumoconiosis were mainly irregular small shadows (2275), s (475), tu (175), ts (275), or irregular shadows. , Sr (175), tp (975), tq (575); a small portion may also appear as small circular shadows [p (675), q (175), pq (375), qp Small circular shadows dominated the two mixed performance [ps (1175), qs (375), qt (175)]. Of 75 patients, 27 cases of X-ray showed a large shadow, of which 20 cases were diagnosed as stage Ⅲ pneumoconiosis, their chest X-ray can see the fusion mass, located in more than two parts of the upper lung area, unilateral mass in 8 cases (40.00%), symmetrical on both sides of the 12 cases (60.00%). CT images show that the mass is gradually gathered and merged by a large number of irregular small shadows, which are mostly in the form of stripes or braids, with the features of uneven density, loose structure and irregular edges. Mediastinal patients, hilar lymph nodes generally increased, calcification, may be associated with pleural thickening. Correlation analysis showed that there was no significant correlation between the degree of lung function impairment and aluminum pneumoconiosis stage (r = 0.015, P> 0.05). Conclusion Short-term, high-concentration exposure to corundum dust can cause severe pneumoconiosis. The hazards of aluminum dust can not be ignored.