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过去诊断尘肺是依靠职业病史和胸部X线拍片。胸片上的异常所见相当晚于肺组织学变化。胸片发现异常所见的阶段,已经是肺内早就存在了吸入粉尘的异常蓄积、局部组织反应,形成了肺纤维化、结节、肺泡破坏等改变。迄今为止,尘肺诊断上存在着的最大问题就是缺乏早期能检测肺内粉尘蓄积的方法。最近的诊断进展就是有了这种方法。 第一是支气管肺泡灌洗液细胞学检查法。 研究用支气管肺泡灌洗法收集的灌洗液中的巨噬细胞和肺内其他细胞,来了解:(1)、肺内是否确实存有粉尘的蓄积;(2)、蓄积的粉尘是否已被巨噬细胞吞噬;(3)、呼吸系统是否存有炎症性病变。 通过对石棉肺病人进行支气管肺泡灌洗液细胞学检查法,结果查见巨噬细胞内确实已有石棉被吞噬,而且持续可达数年以上。
Past diagnosis of pneumoconiosis is dependent on occupational history and chest X-ray film. Abnormal findings on chest radiographs were quite late in lung histology. Abnormal chest X-ray findings of the stage, there is already an abnormal accumulation of inhaled dust in the lungs, local tissue reaction, the formation of pulmonary fibrosis, nodules, alveolar damage and other changes. So far, the biggest problem with pneumoconiosis diagnosis is the lack of early detection of dust accumulation in the lungs. The most recent diagnosis is this method. The first is bronchoalveolar lavage fluid cytology. Study the bronchoalveolar lavage collected by the lavage fluid in the macrophages and other lung cells to understand: (1), the lung is indeed the accumulation of dust accumulation; (2), the accumulation of dust has been Macrophages phagocytosis; (3), the respiratory system is there inflammatory disease. Bronchial alveolar lavage fluid cytology was performed on asbestosis patients. As a result, it was found that asbestos was indeed phagocytosed in macrophages and continued for several years.