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目的了解金属粉尘(锌)肺沉着病患者脱离粉尘作业后的动态影像学变化特征,为金属粉尘(锌)肺沉着病的诊断提供参考依据。方法对1998年就诊于某职业病防治院的4例金属粉尘(锌)肺沉着病患者脱离金属粉尘作业后连续12~18 a的影像学改变进行动态观察,组织5名资深专家对患者的初诊及随访X线胸片进行集体阅片,参考尘肺病诊断标准及标准片,记录小阴影的形态、总体密集度、小阴影分布肺区、尘肺期别,将专家的阅片意见汇总后整理数据。结果该组病例的X线胸片最初诊断均达到尘肺壹期改变,影像学表现以全肺弥漫分布的高密度的圆形小阴影为主,随着脱离粉尘时间的延长,4例患者8个肺区的圆形小阴影数量减少,3例患者已达不到尘肺壹期改变。结论金属粉尘(锌)肺沉着病患者脱尘后,在一定时间内,肺部X线阴影可出现部分自行消退现象。
Objective To understand the dynamic imaging changes of dust-ridden patients with metal dust (zinc) pneumoconiosis and provide a reference for the diagnosis of metal-dust (zinc) pneumoconiosis. Methods Four cases of metal dust (zinc) pneumoconiosis patients attending an occupational disease prevention and treatment hospital in 1998 were dynamically observed after 12 to 18 consecutive days of metal dust removal. Five senior experts were recruited to conduct the first visit and Follow-up X-ray chest for collective reading, reference pneumoconiosis diagnostic criteria and standard films, record the shape of the small shadow, the overall intensity, distribution of small lungs lung area, pneumoconiosis period, the experts read the views after the summary of the data. Results The first diagnosis of X-ray in this group of patients had the first stage of pneumoconiosis. The radiographic manifestations were mainly the high-density circular small shadows with diffuse lung distribution. With the extension of time from the dust, 8 of the 4 patients The number of circular small shadows in the lung area decreased, and 3 patients had not reached the stage of pneumoconiosis. Conclusions After the dust of patients with metal dust (zinc) pneumoconiosis is removed, the X-ray of the lung may appear partial self-subsidence within a certain period of time.