肺功能与动脉血气检测在尘肺病劳动能力鉴定中的应用探讨

Application of pulmonary function and arterial blood gas in labor ability assessment of pneumoconiosis

目的探讨肺功能与动脉血气对尘肺病患者劳动能力鉴定的影响,以及两者检查的差异性,为劳动能力鉴定的应用提供科学依据。方法对湖南省职业病防治院受理劳动能力鉴定的182例尘肺病患者同时进行肺功能与动脉血气测定,对其结果进行对比分析。结果182名尘肺病患者中肺功能异常率占76.9%(140/182),低氧血症占23.1%(42/182),两者的差异有统计学意义(P<0.01),低氧血症随着期别的增高而加重(P<0.01),5项肺功能检测指标中,以残气/肺总量(RV/TLC)、一氧化碳弥散量(DLco)和第1秒用力呼气量(FEV1)异常为主,异常率分别为55.5%、42.9%、35.7%。依据肺功能结果判定劳动能力平均等级为(4.9±1.5)级,依据动脉血气结果判定劳动能力平均等级为(6.2±1.5)级,2种不同指标判定劳动能力等级有明显的差异(P<0.01)。结论肺功能检测和血气分析在劳动鉴定中差异较大,在加强检查质量控制的同时,应综合评定肺功能损伤程度,以提高鉴定结果的准确性和可靠性。

〈Objective To explore the effects and correlations of pulmonary function and arterial blood gas in labor ability assessment of pneumoconiosis.,in order to provide the scientific data for the labor ability assessment.Methods The labor ability of 182 pneumoconiosis patients in our hospital were assessed by using pulmonary function and arterial blood gas.Results The abnormal rates of pulmonary function and arterial blood gas were 76.9%（140/182）and 23.1%（42/182）respectively.There was significant difference between the two imethods.In 5detective index of the pulmonary function,the main abnormal indexes were RV/TLC%、DLco% and FEV1%,and the rate were55.5%、42.9%、35.7% respectively.There are obvious differences between the damage of lung function and hypoxemia to determine the labor capacity grade（P 0.01）.Conclusions The results of pulmonary function and arterial blood gas had significant differences in the labor ability assessment.We should strengthen the quality control for the comprehensive evaluation of the lung function damage to improve the accuracy and reliability of the identification results.