目的探讨矽肺病发生发展规律,明确晚发型矽肺的诊断要点。方法调查15例晚发型矽肺患者的职业史;将确诊其矽肺病的X射线胸片,与其刚脱离粉尘岗位时(或以后)所拍摄的、属正常范畴的X射线胸片作仔仔细细的比对分析,以了解所有矽结节的形态、密集度的发展变化。结果在高浓度、高游离二氧化硅含量的粉尘环境中工作过的15例职工,其接触矽尘的工龄12至37年(平均23.2年),刚脱离矽尘岗位时摄胸片体检尚属正常,然而过了4至27年后却检出了矽肺;比对分析各例患者的所有胸片,发现其X射线征象改变主要表现是在矽结节密集度的增高方面,也有部分可追溯到矽结节形态增大的迹象。结论在生产过程中吸入了一定量的含有游离二氧化硅的粉尘后,即使在刚脱离粉尘环境时尚属于正常,过了若干年仍有少许人员可能发展为矽肺病人;对接触矽尘的职工,离职后的定期拍摄X射线胸片检查不容忽视。 Objective To investigate the occurrence and development of silicosis and to make clear the diagnostic points of late-onset silicosis. Methods The occupational history of 15 patients with late-onset silicosis was investigated. The X-ray chest diagnosed with silicosis was compared with the X-ray chest of the normal category which was taken immediately after (or after) leaving the dust post Comparison analysis to understand the shape and density of all silicon nodules. Results The 15 workers who worked in dust environment with high concentration and high free silica content had 12 to 37 years (average 23.2 years) of exposure to silica dust. The examination of chest radiograph Normal, however, silicosis was detected after 4 to 27 years; comparing all the chest radiographs of the patients in each case, it was found that the main manifestations of the X-ray changes were the increase in the intensity of the nodules and some of them were traceable Silicon nodules to the signs of increased form. Conclusions After inhaling a certain amount of dust containing free silica during the production process, even after just being detached from the dust environment, it is normal for some people to develop silicosis after a few years. For workers exposed to silica dust, After the regular shooting X-ray chest radiography can not be ignored.