2006-2018年四川省退伍铁道兵尘肺病影像学特征分析
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摘要
目的通过对四川省退伍铁道兵尘肺病例的影像资料进行回顾性调查,描述其影像学特征。方法收集2006-2018年四川省疾病预防控制中心门诊部诊断为尘肺病的退伍铁道兵尘肺病例的高千伏胸片,对其影像学表现、期别、并发症等进行统计分析。结果 740例退伍铁道兵尘肺病例的高千伏胸片中,壹期和贰期共计704例,X射线胸片均表现为圆形小阴影,以p影为主,共有529例(71.49%),矽肺叁期的高千伏胸片表现为大阴影。矽肺壹期的小阴影主要分布于中下肺区的有375例(65.10%);矽肺贰期小阴影主要分布于上中下肺区,有90例(70.31%)。矽肺叁期患者大阴影多分布于上中肺区21例(58.33%)。结论四川的退伍铁道兵尘肺以壹期为主,这是由于这部分人群接尘时间短,大部分人群在初次诊断后没有按要求定期复查。这就要求职业卫生工作者应针对这部分已经脱离粉尘作业的特殊人群建立健全职业健康监护档案,督促其定期复查,以便及时掌握其尘肺病的进展情况。
Objective By reviewing the imaging data of railway ex-soldiers with pneumoconiosis in Sichuan province, the radiologic features were described. Methods High-kv chest films of pneumoconiosis cases diagnosed by the outpatient department of Sichuan center for disease control and prevention from 2006 to 2018 were collected. The imaging manifestations, disease stages and complications were statistically analyzed. Results Among the 740 high-kv chest radiographs of the pneumoconiosis cases, there were 704 cases in stage I and stage II, the X-ray chest radiographs showed small round shadows, most of them were p shape(529 cases), accounting for 71.49%.The HKV sternums of silicosis in stage Ⅲ showed large opacities. In 375 cases,the small shadows of stage I silicosis were mainly distributed in the lower and middle lung regions, accounting for65.10%. In 90 cases,the small shadows of stage II silicosis were mainly distributed in the upper,the middle and the lower lung area, accounting for 70.31%. For stage Ⅲ silicosis patients, large shadows are mostly distributed in the upper and middle lung areas(21 cases), accounting for58.33%. Conclusion The pneumoconiosis of railway ex-soldiers with in Sichuan province is mainly at the stageⅠ,this may because this part of the ex-soldiers had been exposed to the dust for a short time, most of the population did not follow the requirements of regular review after the initial diagnosis. This requires that occupational health workers should establish and improve occupational health monitoring files for this part of the special population that had been separated from dust operations, then urge them to regularly review,so as to timely grasp their progress of pneumoconiosis.
Objective By reviewing the imaging data of railway ex-soldiers with pneumoconiosis in Sichuan province, the radiologic features were described. Methods High-kv chest films of pneumoconiosis cases diagnosed by the outpatient department of Sichuan center for disease control and prevention from 2006 to 2018 were collected. The imaging manifestations, disease stages and complications were statistically analyzed. Results Among the 740 high-kv chest radiographs of the pneumoconiosis cases, there were 704 cases in stage I and stage II, the X-ray chest radiographs showed small round shadows, most of them were p shape(529 cases), accounting for 71.49%.The HKV sternums of silicosis in stage Ⅲ showed large opacities. In 375 cases,the small shadows of stage I silicosis were mainly distributed in the lower and middle lung regions, accounting for65.10%. In 90 cases,the small shadows of stage II silicosis were mainly distributed in the upper,the middle and the lower lung area, accounting for 70.31%. For stage Ⅲ silicosis patients, large shadows are mostly distributed in the upper and middle lung areas(21 cases), accounting for58.33%. Conclusion The pneumoconiosis of railway ex-soldiers with in Sichuan province is mainly at the stageⅠ,this may because this part of the ex-soldiers had been exposed to the dust for a short time, most of the population did not follow the requirements of regular review after the initial diagnosis. This requires that occupational health workers should establish and improve occupational health monitoring files for this part of the special population that had been separated from dust operations, then urge them to regularly review,so as to timely grasp their progress of pneumoconiosis.
引文
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[13]王迅.应用X线诊断肺结核与尘肺病的临床鉴别与影像学表现分析[J].影像研究与医学应用,2018,2(14):66-67.
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[15]GBZ188-2007职业健康监护技术规范[S].2007.
[16]秦克江,叶绍色,王力珩.尘肺病初诊患者进入尘肺病正式诊断复诊阶段的情况及其影响因素[J].广西医学,2017,39(10):1486-1489.
[2]曾瑞敏.X线胸片及CT诊断Ⅱ期矽肺的对比研究[J].中国地方病防治杂志,2015,30(3):234.
[3]黄登花.尘肺大阴影高千伏摄影与高分辨率CT的影像学对照分析[J].中国CT和MRI杂志,2014,12(5):53-54.
[4]麦志丹,李小萍,梁德新,等.广西壮族自治区2005-2009年尘肺报告病例的分析[J].工业卫生与职业病,2012,38(3):171-173.
[5]国家卫生计生委疾病预防控制局.2015-2016年全国职业病报告情况[J].职业卫生与应急救援,2018,36(1):93.
[6]李宏,沈国安,兰亚佳,等.四川省尘肺病例分布现状[J].职业卫生与病伤,2006(1):1-4.
[7]铁道兵历史沿革及发展-活跃在工程建设战线的英雄“部队”[J].建设机械技术与管理,2014,27(6):48-51.
[8]李德鸿.尘肺病[M].北京:化学工业出版社,2010:90.
[9]梁杰.尘肺病影像诊断效果观察[J].当代医学,2016,22(15):45-46.
[10]冯启慧.矽肺的医学影像学研究进展[J].吉林医学,2016,37(4):948-951.
[11]王丽佳,李春艳.矽肺的X线诊断分析[J].世界最新医学信息文摘,2017,17(53):142-146.
[12]袁智勇,马兵,李勇,等.矽肺小阴影早期肺内分布的影像学特点[J].预防医学情报杂志,2011,27(5):353-354.
[13]王迅.应用X线诊断肺结核与尘肺病的临床鉴别与影像学表现分析[J].影像研究与医学应用,2018,2(14):66-67.
[14]王静,彭秀苗,蔡俊丽,等.济南市2008-2017年尘肺病发病特征及趋势分析[J].中国公共卫生管理,2018,34(5):592-595.
[15]GBZ188-2007职业健康监护技术规范[S].2007.
[16]秦克江,叶绍色,王力珩.尘肺病初诊患者进入尘肺病正式诊断复诊阶段的情况及其影响因素[J].广西医学,2017,39(10):1486-1489.