吸入治疗缓解以肺不张、肺部团块为影像表现的尘肺症状

Effect of inhalation therapy to alleviate pneumoconiosis symptoms of atelectasis and pulmonary mass

目的探讨尘肺病的临床特点及诊治方法。方法报道1例49岁男性,以肺不张、肺部团块为影像表现的尘肺病例的诊治。结果患者胸部CT示右上肺节段性不张、左上肺占位灶,结合病史体征、生产性粉尘接触史及辅助检查,排除肺部类似疾病后,遂考虑"尘肺(矽肺)"诊断。予吸入糖皮质激素、支气管扩张剂等治疗后咳嗽缓解、肺部干啰音明显减少。结论 CT和纤支镜检查对肺部大阴影为特征X线表现的Ⅲ期尘肺病与肺结核、肺部肿瘤的鉴别诊断有很大价值。

Objective To investigate the clinical characteristics of pneumoconiosis and to discuss its diagnosis and treatment. Methods There was 1 case of 49 years old male patient, who was diagnosed as pneumoconiosis with atelectasis and pulmonary mass ima- ging manifestation. Results The CT scan showed right upper pulmonary had segmental atelectasis and left superior pulmonary had le- sions. Combined with clinical manifestations, contact history of production dust and accessory examinations, the patient was diagnosed as pneumoconiosis, excluding other lung diseases similar to pneumoconiosis. The patient＇s cough symptom and lung rales were significantly relieved by the inhalation of glucocorticoid and bronchodilators. Conclusion CT and fiberoptic bronchoscopy have great value in the differential diagnosis of pulmonary shadow in X-ray manifestations among patients with pneumoconiosis at stage III, patients with pulmonary tuberculosis and patients with lung tumor.