慢性黄磷中毒20年研究及诊断标准探讨

A Study on 20 Years of Yellow Phosphorus Poisoning and An Inquiry into its Diagnostic Criterion

对189名黄磷生产工人连续5年体检发现,4年工龄组工人牙体和牙周患病率分别为58.2％、37.6％,与3年工龄组及对照组比较差异有显著性意义(P<0.001)。3～5年工龄组X线摄片,下颌骨受损害者56.9％。同一患者兼有齿槽骨质吸收与局部密度增高为其显著特点(占93.9％),发病与工龄呈高度正相关(r=0.965,P<0.001)。 对脱离黄磷生产15年的31例患者进行随访,其中11例由Ⅰ期进展为Ⅱ期,8例进展为Ⅲ期。有3例下颌骨X线片呈多囊样或脓肿样改变,属罕见病例。 本文对慢性黄磷中毒的诊断标准进行了讨论,建议以X线检查为主要依据,按照颌骨损害范围和程度将其分为三期。

It was found, after four consecutive yearsof physical checkups on 189 workers of yellowphosphorus production, that the incidences oftooth disease and periodontal disease in wor-kers of four years of service were 58.2% and37.6% respectively. They were significant (P<0.01) compared with workers of three yearsof service and those on the control group.X-ray pictures showed that 56.9% of workerswith 3 to 5 years of service had mandibularinjuries. A striking feature was that the pa-tient had at once osteoporosis and local calci-fication (accounting for 93.9%), and the inci-dence was positive in correlation with yearsof service (r=0.965, P<0.01). Follow-up visits were paid to 31 patientswho had not contact yellow phosphorus pro-duction for 15 years. Among them, 11 deve-loped from stage Ⅰ to stage Ⅱ, and 8 to stageⅢ. 3 cases showed porosity-or abscess-likechanges in mandibular X-ray pictures, whichwere rather rare. This article attempted to discuss on thediagnostic criterion of chronic yellow phospho-rus poisoning and suggested a classificationof 3 stages according to the range and degreeof mandibular injury, on the basis of X-rayfindings.