摘要
目的探讨高分辨率CT(high resolution CT,HRCT)在职业性尘肺病诊断中的优势,提高诊断的准确性。方法通过对南通市疾病预防控制中心2017年1月—2020年12月受理诊断的108例有明确粉尘接触史的劳动者进行胸部HRCT和直接数字化X线摄影(digital radiography,DR)检查,比较2种检查方法对尘肺阴影的检出差异。结果HRCT对尘肺小阴影及纤维索条影的检出率高于DR,差异有统计学意义(χ^(2)=5.082,P=0.024;χ^(2)=9.008,P=0.003);在接触电焊烟尘作业者中,HRCT对肺部小阴影及纤维索条影检出率明显高于DR,差异有统计学意义(χ^(2)=4.446,P=0.035;χ^(2)=6.093,P=0.014);在接触矽尘作业者中,2种检查方法对肺部小阴影、小阴影聚集、大阴影及纤维索条影的检出,差异无统计学意义(χ^(2)=0.971,P=0.324;χ^(2)=0,P=1.000;χ^(2)=2.318,P=0.128);HRCT对肺大泡、肺内钙化灶、肺部感染和纵隔肺门淋巴结肿大的检出率高于DR,差异有统计学意义(χ^(2)=11.879,P=0.001;χ^(2)=3.946,P=0.047;χ^(2)=5.474,P=0.019;χ^(2)=18.667,P<0.001)。结论HRCT能早期发现尘肺小阴影及纤维索条影,尤其对早期电焊工尘肺的诊断意义重大;对早期发现尘肺肺部合并症及鉴别诊断有重要意义;在今后诊断工作中,将DR与HRCT联合应用,可提高诊断的准确性。
Objective This study aimed to explore the advantages of high resolution CT(HRCT)in the diagnosis of occupational pneumoconiosis and to improve the accuracy of diagnosis.Methods Chest HRCT and digital radiography(DR)were performed on 108 workers with a clear history of dust exposure diagnosed by Nantong Center for Disease Control and Prevention from January 2017 to December 2020,and the difference of pneumoconiosis shadows by the two methods was compared.Results The detection rate of HRCT on pneumoconiosis small shadow and fibrous streak shadows was higher than that of DR,and the difference was statistically significant(χ^(2)=5.082,P=0.024;χ^(2)=9.008,P=0.003).Among workers exposed to welding fumes,the detection rate of small lung shadows and fibrous cord shadows by HRCT was higher than that of DR,and the difference was statistically significant(χ^(2)=4.446,P=0.035;χ^(2)=6.093,P=0.014).Among workers exposed to silica dust,there was no statistically significant difference between the two methods in the detection of small shadow,small shadow aggregation,large shadow and fiber cord shadow(χ^(2)=0.971,P=0.324;χ^(2)=0,P=1.000;χ^(2)=2.318,P=0.128);the detection rates of pulmonary bullae,pulmonary calcification foci,pulmonary infection and mediastinal hilar lymph node enlargement by HRCT were higher than those by DR,the differences were statistically significant(χ^(2)=11.879,P=0.001;χ^(2)=3.946,P=0.047;χ^(2)=5.474,P=0.019;χ^(2)=18.667,P<0.001).Conclusion HRCT can detect the small shadows and fibrous streak shadows of pneumoconiosisin the early stage,especially for the early diagnosis of pneumoconiosis in electric welders.It is also of great significance for early detection of pneumoconiosis and pulmonary complications and the differential diagnosis.In the diagnosis work,the accuracy of diagnosis can be improved by combining DR with HRCT.
作者
张荣荣
刘巧
杨小梅
毛叶挺
陆聪
ZHANG Rongrong;LIU Qiao;YANG Xiaomei;MAO Yeting;LU Cong(Nantong Center for Disease Control and Prevention,Nantong,Jiangsu 226007,China;不详)
出处
《医学动物防制》
2023年第12期1151-1154,1159,共5页
Journal of Medical Pest Control
基金
江苏省卫生健康委员会科研面上项目(M2020020)。
关键词
尘肺病
高分辨率CT
直接数字化X线成像
电焊工尘肺
矽肺
分析
Pneumoconiosis
High resolution CT
Direct digital X-ray imaging
Welders′pneumoconiosis
Silicosis
Analysis
