矽肺死亡病例分析

ANALYSIS OF THE DEAD CASES OF SILICOSIS

[目的]探讨矽肺发展规律,预测今后若干年矽肺发病趋势。[方法]选取1970-2006年新疆乌鲁木齐铁路局矽肺死亡病例525例进行了回顾性分析,对死亡病例的合并症以及肺功能损伤程度及障碍进行分析,并对结果进行统计学分析。[结果]①矽肺死亡病例最多见并发症为慢性支气管炎急性发作、慢性阻塞性肺气肿,为100%;慢性肺源性心脏病、肺结核、糖尿病、气胸、冠心病等也很常见。②各期矽肺死亡病例中肺功能损害差异有统计学意义,轻度肺功能损害在各期均少,其中Ⅰ期矽肺以中度损伤为主,Ⅱ、Ⅲ期以重度损伤为主。③矽肺死亡病例肺功能障碍Ⅰ期以阻塞型和混合型通气障碍为主,Ⅱ、Ⅲ期以限制型通气障碍和混合型通气障碍为主。[结论]应积极预防、早期发现和及时治疗矽肺并发症。长期接触高浓度的生产性粉尘对肺功能的损害作用明显,而且损害的程度随着病期的进展而加重,因此肺功能的检查对矽肺全面诊断、病情演变的动态观察及劳动能力鉴定等有着重要的参考价值。

[Objective] To discuss the developmental rule and to forecast the developmental trend of silicosis. [Mothods] A retrospective analysis was carried out to 525 dead cases in Xinjiang railroad bureau from 1970 to 2006. The combinational symptoms, the destroy degree and the dysfuction of lung function were analyzed concretely. [ Results] The combinational symptoms were brought considerably in the dead cases of silicosis. The extent of hmg funtion destroy in the first grade silicosis was in the middle, but the extents of lung funtion destroy in the second and third grade silicosis were severe. The first grade silicosis had mainly obstructive ventilatory impairment and mixed ventilatory impairment, whereas the second anti third grade silicosis had restrictive ventilatory impairment and mixed ventilatory impairment. [ Conclusion ] The combinational symptoms of the silicosis patients should be prevented and treated immediately. The examination of lung funtion is necessary so that we can observe the changes of the development of silicosis and identify the working ability of these patients.