老年退伍铁道兵晚发性矽肺临床观察

An epidemiological survey on delayed silicosis of railway ex-soldiers

目的探讨老年退伍铁道兵迟发型矽肺的临床特征和发病规律,为其防治提供科学依据。方法回顾性分析广东省某县320例老年铁道兵退伍兵的临床资料。结果 320例老年铁道兵退伍兵检出晚发性矽肺40例,检出率12.5%。矽肺确诊平均年龄(59.2±1.6)岁,平均接尘工龄(5.3±1.9)年,平均脱尘时间(33.8±2.1)年;呼吸道症状主要表现为胸闷、气促,X线胸片以圆形小阴影q影多见,肺通气功能异常率为57.5%;劳动能力鉴定示伤残等级4级至2级者占60.0%。结论老年退伍铁道兵晚发性矽肺检出率高,发病年龄较大,接尘工龄短,脱尘时间长,劳动能力损害较严重。应建立合理有效机制,加强对退伍兵的晚发性矽肺的防治。

Objective To probe into the clinical epidemiological characteristics of delayed silicosis of veteran railway corps,in order to put forward scientific evidences for its prevention and treatment.Methods The clinical data of 320 veteran railway corps in a county of Guangdong Province were analyzed retrospectively.Results 40 patients of 320 cases of veteran railway corps were diagnosed as delayed silicosis with an incidence rate of 12.5%.The average age of onset was（59.2±1.6）years and the duration of dust exposure was（5.3±1.9）years respectively.The average time from non-dust exposure to silicosis confirmation was（33.8±2.1）years.The major respiratory symptoms were chest tightness and shortness of breath.Chest radiographic examination showed mainly small round opacities-＂q＂ shape.The abnormity rate of pulmonary ventilation function was 57.5%.The identification of labor ability showed that the degree of body impairment up to Degree 4 to Degree 2 were 60.0%.Conclusion Higher incidence,older age of onset,shorter duration of dust exposure,longer time from non-dust exposure to silicosis confirmation,and the higher grade of body impairment may be the main epidemiological characteristics of delayed silicosis in veteran railway corps.It＇s suggested that rational and effective management mechanism be established to strengthen the prevention and treatment for delayed silicosis of veterans.