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目的了解山西省忻州市改水降氟防治饮水型氟中毒效果及病情流行动态。方法按照《山西省地方性氟中毒监测方案》进行,水氟测定按照《生活饮用水标准检验方法》(GB/T5750-2006),尿氟采用氟离子选择电极法(WS/T89-1996);氟斑牙采用Dean法,临床氟骨症和X线氟骨症诊断采用《地方性氟骨症诊断标准》(WS/T192-2007)。结果累计改水降氟221处,覆盖病区村230个,覆盖率为80.7%,受益人口28.2万,占病区总人口的70.3%。检测居民饮用水462份,水氟均值为1.08㎎/L,范围值0.56～4.97㎎/L。检查8～12岁儿童氟斑牙7 352人,总检出率21.87%,氟斑牙指数为0.49。测定儿童尿样1 368份,总样本尿氟几何均值为1.67㎎/L,范围值0.52～15.36㎎/L。检查16岁以上人群31 728人,检出临床氟骨症患者4 935例,总检出率为15.55%,共X线拍片622人,检出X线氟骨症163人,检出率26.21%。结论忻州市改水降氟取得了可喜的成效,饮水型氟中毒病情得到控制;但在局部病情流行还较为严重,防治工作仍然任重道远。
Objective To understand the effects of changing water and reduce fluoride in prevention and treatment of drinking water fluorosis in Xinzhou City, Shanxi Province, and the epidemiology of the disease. Methods According to the “Shanxi fluorosis monitoring program”, water fluoride was determined according to “Standard Test Method for Domestic Drinking Water” (GB / T5750-2006) and fluoride ion selective electrode method (WS / T89-1996). Dental fluoroscopy was performed using the Dean method, clinical skeletal fluorosis, and x-ray fluorosis using the diagnostic criteria for endemic fluorosis (WS / T192-2007). As a result, a total of 221 places were demolished and fluoride was decontaminated, covering 230 ward villages with a coverage rate of 80.7%. The beneficiary population was 282,000, accounting for 70.3% of the total ward population. 462 drinking water samples were tested. The average fluoride content in water was 1.08㎎ / L, ranging from 0.56 to 4.97㎎ / L. A total of 7 352 dental fluorosis children aged 8-12 years were examined. The total detection rate was 21.87%. The dental fluorosis index was 0.49. A total of 1 368 urine samples were determined. The geometric mean urine fluoride content of the total samples was 1.67 ㎎ / L, ranging from 0.52 to 15.36 ㎎ / L. A total of 31 728 people over the age of 16 were examined. A total of 4 935 clinical skeletal fluorosis patients were detected, with a total detective rate of 15.55%. A total of 622 X-ray films were obtained. 163 skeletal fluorosis patients were detected, with a detection rate of 26.21% . Conclusion Xinzhou City, water and fluoride fluoride achieved gratifying results, drinking water fluoride poisoning conditions have been controlled; but the prevalence of the disease is still more serious, prevention and control work is still a long way to go.