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长期以来,胸部X线检查是尘肺诊断的主要手段,但对早期病例或鉴别诊断仍存在着一定困难。意大利Monaco地区在1943—1957年期间接尘工人共死亡4,173人,经尸检确诊为矽肺病的有452例,矽肺合并结核42例,其中生前已经确诊的仅占50％。国内通过尸检确诊为尘肺的报告也屡见不鲜。尸检确诊虽可为尘肺的诊断和科研提供重要的依据,但未能在病员生前予以确诊,无助于预防和治疗,因此,从安全有效为前提,开展肺活检是有其临床价值的。
For a long time, chest X-ray examination is the main method of pneumoconiosis diagnosis, but there are still some difficulties in early cases or differential diagnosis. In the Monaco region of Italy, 4,173 dust-polluting workers died during 1943-1957. 452 were diagnosed as silicosis by autopsy and 42 by silicosis with tuberculosis, of which only 50% had been confirmed before their death. Domestic autopsy confirmed pneumoconiosis reports are also common. Although the diagnosis of pneumoconiosis can provide an important basis for the diagnosis and research of pneumoconiosis, the autopsy can not be diagnosed before the patient’s life, which is not helpful in the prevention and treatment. Therefore, it is of clinical value to carry out lung biopsy on the premise of safe and effective.