摘要
目的 通过综合分析疑似职业性硬金属肺病现场职业卫生学资料和临床资料,掌握职业性硬金属肺病的临床特征和疾病的预后,提高职业性硬金属肺病的诊疗水平.方法 以2名疑似硬金属肺病的工人为研究对象,统一要求其提供职业史、职业健康体检结果、既往就诊病历,采用实验室检查、拍摄系列普通高仟伏胸片和胸部CT、HRCT片、纤维支气管镜做病理检查、心电图检查等方法,分别由3家机构的呼吸科专家、病理科专家对胸片、CT片和病理切片进行读片,并出具诊断报告,提交至职业病诊断机构,由诊断机构组织进行现场职业卫生学调查,由3名以上职业病诊断医师共同讨论诊断,得出职业病诊断结论.结果 2例硬金属肺病患者均接触硬质金属合金粉尘,发病工龄8～9年;临床表现以干咳,活动后气喘为主,两肺呼吸音粗;影像学改变以两肺弥漫性结节状影、网状阴影和毛玻璃样改变为主;病理表现为特征性的巨细胞间质性肺炎改变,疾病治疗的预后和转归不一.结论 根据确切的职业接触史及临床表现,结合X线胸片、CT片检查结果和病理学特征性改变,可以确诊职业性硬金属肺病.
Objective We sought to master the clinical characteristics and prognosis of hard mental lung disease,improving this disease＇s diagnosis and treatment quality.Methods We recruited two suspected patients with hard mental lung disease and collected their occupational history,examination results of occupational health,and past medical records.By virtue of laboratory tests,high Kv chest radiography,CT and HRCT of chest,fiberoptic bronchoscopy and ECG examination,diagnostic report was synthesized respectively by respiratory physicians and pathologist from three different agencies.Then the report was submitted to diagnosis organizations of occupational disease,and diagnostic conclusion of occupational disease was drawn after discussion by at least three diagnosticians of occupational disease.Results We found that both of the two suspected patients were exposed to dusts of hard metal,and length of exposure service ranged from 8 to 9 years.Clinical manifestations were dominated by dry cough,wheezing after activities,and pathological manifestation was characteristic giant cell interstitial pneumonia.The prognosis and outcome of the disease were different.Conclusion According to exact occupational exposure history,clinical manifestations,combined with the results of high Kv chest radiography,CT of chest and pathological manifestation,it can be diagnosed with hard mental lung disease.
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
2015年第1期45-48,共4页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
江苏省精铸行业锆英砂粉尘危害的现况调查及硅酸锆检测方法的建立（Y2013049）
江苏省医学领军人才与创新团队项目（LJ201130）
关键词
职业暴露
硬金属肺病
Occupational exposure
Hard mental lung disease
