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目的认识氧化铁粉尘肺沉着病的病因和特点。方法对1名接触氧化铁粉尘10余年的患者的胸部数字化X射线摄影(DR)片、高仟伏胸片、X射线电子计算机断层扫描(CT)片、大容量肺灌洗液、肺功能等检查结果结合现场职业卫生学调查资料进行综合分析。结果患者所在岗位粉尘时间加权平均浓度(CTWA)为9.4 mg/m3。胸片见两肺弥漫分布的直径为2~3 mm的结节阴影,以两中、下肺区为著,心膈影未见异常。胸部CT片与胸片结果一致。肺灌洗液呈铁锈色,集菌未找到抗酸杆菌,细菌培养、真菌培养均阴性。肺功能检查提示轻度限制性通气功能减退。血肿瘤标志物、血结核抗体、呼吸道感染病原体Ig M九联检均阴性。结论长期接触高浓度的氧化铁粉尘可致氧化铁粉尘肺沉着病,该病发病工龄较长,症状、体征较少,X线胸片表现为点状、结节状阴影。
Objective To understand the etiology and characteristics of iron oxide dust pneumoconiosis. Methods Thorax digital radiography (DR) radiograph, high kV chest radiograph, X-ray computed tomography (CT) radiograph, high-capacity lung lavage fluid, pulmonary function, etc. were performed on a patient exposed to iron oxide dust for more than 10 years. Inspection results combined with on-site occupational hygiene survey data for a comprehensive analysis. Results The time-weighted average dust concentration (CTWA) of the patients was 9.4 mg / m3. See the diffuse chest radiographs of 2 to 3 mm in diameter, nodular shadow, in the two, the lower lung area, no abnormal diaphragmatic shadow. Chest CT results consistent with chest radiograph. Lung lavage showed rust color, bacteria found no acid-fast bacilli, bacterial culture, fungal culture were negative. Pulmonary function tests suggest mild restrictive ventilatory dysfunction. Blood tumor markers, blood TB antibodies, respiratory tract infection IgM nine joint test were negative. Conclusion Long-term exposure to high concentrations of iron oxide dust can cause iron dust pneumoconiosis, the longer onset of the disease, fewer symptoms and signs, X-ray showed dot-like, nodular shadows.