论文部分内容阅读
目的观察锡冶炼工尘肺病患者胸部影像学改变和转归情况。方法对10例锡冶炼工尘肺病病例进行胸部X射线和电子计算机断层扫描(CT)摄影及动态观察,分析其肺部影像学特点和转归情况。结果 10例锡冶炼工尘肺病患者的临床症状轻微,未见合并肺结核,肺通气功能改变不明显。诊断时X射线高千伏胸片结果显示:两肺小阴影形态以圆形为主,多分布在双肺中上肺区;多数病例肺纹理扭曲、变形或增多、模糊,肺门影增大增粗,淋巴结点状钙化,个别状如蛋壳,未见胸膜改变和肺气肿改变;5~10年的动态观察除1例患者小阴影增多外,其余均未见明显改变。2011年胸部CT检查可见2~5 mm的结节状影;其中,7例患者小结节从两上肺叶均匀分布至中叶、两肺下叶背段,下叶基底段病变减少;病变呈弥漫分布全肺叶,且胸膜下有小结节者3例;小叶间隔不同程度增厚5例;有小叶中心型或间隔旁肺气肿4例;其中1例有肺大泡形成。10例患者2016年胸部CT检查结果与2011年比较,弥漫性肺结节增多2例,小叶间隔增厚明显3例,肺气肿有进展2例。结论锡冶炼工尘肺病患者肺部小阴影经5~10年的X射线动态观察未见明显吸收,且病变有进展。CT检查有助于对锡冶炼工尘肺病进行追踪观察。
Objective To observe the changes of thoracic imaging and prognosis of tin smelters with pneumoconiosis. Methods Thoracic X-ray and computed tomography (CT) photography and dynamic observation were performed on 10 cases of tin-smelting workers with pneumoconiosis. The characteristics of lung imaging and the prognosis were analyzed. Results The clinical symptoms of 10 cases of tin smelting workers with pneumoconiosis were mild with no pulmonary tuberculosis. The changes of lung ventilation were not obvious. X-ray diagnosis of high kV chest X-ray results showed that: the two small lung shadow shape mainly round, mostly in the lungs in the upper lung area; most cases of lung texture distortions, deformation or increase, blur, increased hilar shadow Thickening, nodular lymph node calcification, individual like egg shell, no change in pleura and emphysema; 5 to 10 years of dynamic observation in addition to a small increase in patients with small shadow, the rest were no significant changes. 2011 chest CT examination showed 2 ~ 5 mm nodular shadow; of which 7 patients with small nodules evenly distributed from the upper lobe to the middle of the leaves, both lungs under the leaf segment, lower basal segment lesions decreased; lesions were diffuse Distribution of the whole lobe, and a small subpleural nodules in 3 cases; interlobular septa in varying degrees of thickening in 5 cases; lobular center or interval next to emphysema in 4 cases; of which 1 case of bullae formation. In 10 patients, chest CT findings in 2016 were compared with those in 2011. There were 2 cases of diffuse pulmonary nodules, 3 cases of interlobular septal thickening and 2 cases of emphysema. Conclusion There is no obvious absorption of X-ray dynamic observation of small lung shadow in patients with tin smelter pneumoconiosis after 5 to 10 years, and the progress of the lesion. CT examination can help to observe the tin smelter pneumoconiosis.