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[目的]分析应用高分辨率电子计算机断层扫描(HRCT)对粉尘作业人员早期肺气肿的检出情况,为实施职业健康监护干预提供依据。[方法]对312例粉尘作业职业健康监护观察对象进行分析,其中136例接触电焊粉尘,119例接触其他致尘肺粉尘,57例接触不引起法定尘肺的其他粉尘。全部人员经内科胸部检查、高千伏胸片、HRCT及肺功能检查。[结果]高千伏胸片检查均未见肺气肿表现。HRCT检查发现早期肺气肿51例,其中电焊作业人员29例,其他致尘肺粉尘作业人员18例,不致法定尘肺的其他粉尘作业人员4例,检出率分别为21.3%、15.1%和7.0%(χ2=6.30,P<0.05);且接尘工龄越长,检出率越高(χ2=14.59,P<0.001);年龄≥50岁组早期肺气肿检出率高于<50岁组。[结论]粉尘作业人员早期肺气肿的检出率与年龄、接尘时间、接尘种类有关,电焊工早期肺气肿检出率高。建议对年龄≥50岁的接触电焊粉尘工人优先开展HRCT检查。
[Objective] To analyze the detection of early emphysema in dust workers by using high-resolution computed tomography (HRCT), and provide evidence for the intervention of occupational health care. [Methods] 312 occupational health monitoring objects were analyzed. Among them, 136 were exposed to welding dust, 119 were exposed to dust pneumoconiosis, and 57 were exposed to other dusts that did not cause statutory pneumoconiosis. All staff by the medical examination of the chest, high kV chest radiography, HRCT and pulmonary function tests. [Results] High kV chest X-ray examination showed no emphysema. HRCT examination found 51 cases of early emphysema, including 29 welding workers, 18 other dust-causing dust workers and 4 other dust-free workers without statutory pneumoconiosis. The detection rates were 21.3%, 15.1% and 7.0% respectively, (χ2 = 6.30, P <0.05). The longer the service life, the higher the detection rate (χ2 = 14.59, P <0.001) . [Conclusion] The detection rate of early emphysema in dust workers is related to the age, dust collection time and the type of dust, and the detection rate of early emphysema in welders is high. It is recommended to give priority to HRCT inspection of workers exposed to dust over 50 years of age.