振动性白指工人冷水复温试验皮温变化特征

Characteristic changes of finger skin temperature in cold provocation test in workers with vibration white finger

目的分析振动性白指(VWF)工人冷水复温试验(CPT)的皮温变化特征。方法采用随机数字表法,以245名从事手传振动作业的男性工人为研究对象,根据是否出现VWF分为VWF组(73人)和对照组(172人)。对2组工人进行试验条件为10℃、10 min的CPT,测量双手食指、中指、无名指CPT前适应期(0、10、20、30 min的时间点)和CPT后不同时间(0、5、10、15、20、25、30 min时间点)的皮温。结果 CPT皮温在分组与时间的交互效应上有统计学意义(P<0.01);CPT前的适应期,2组人群适应10和30 min时间点皮温分别比较,差异均无统计学意义(P>0.05);CPT后,VWF组人群除5 min时间点皮温低于同时间点对照组(P<0.05)外,其余时间点手部皮温与对照组比较,差异均无统计学意义(P>0.05)。CPT后,2组人群皮温均以0 min的时间点最低(P<0.05),且皮温均呈随时间的推移而上升的趋势(P<0.01),但CPT后30 min时间点皮温均未恢复至CPT前适应30 min时的正常皮温水平。VWF组人群左手食指、右手食指、右手无名指的5 min复温异常检出率均高于对照组(72.6%vs56.4%,75.3%vs 57.6%,86.3%vs 65.1%,P<0.05);2组人群6个手指的10、30 min复温异常检出率分别比较,差异均无统计学意义(P>0.05)。VWF组人群左手食指与右手食指、右手食指与右手无名指的5 min复温异常检出率分别比较,差异均无统计学意义(72.6%vs 75.3%,75.3%vs 86.3%,P>0.05)。结论对手传振动作业工人进行条件为10℃、10 min的CPT时,建议首选食指进行测量;CPT前的适应时间可调整为10 min。

Objective To analyze the changes of finger skin temperature in cold provocation test （CPT） in workers with vibration white finger （VWF）. Methods A total of 245 male workers engaged in hand arm vibration operation was selected as study subjects using random number table method. All subjects were divided into VWF group （73 persons） and control group （172 persons）. CPT （10 ℃, 10 min） was performed and the skin temperature of 6 fingers （index finger, middle finger and ring finger of both hands） was measured at pre-CPT adaptation period （0, 10, 20, 30min） and after CPT period （0, 5, 10, 15, 20, 25, 30 min）. Results The effect of interaction between grouping and observe time was statistically significant on finger skin temperature （P 〈 0. 01 ）. In the pre-CPT adaptation period, there was no statistically significant difference on skin temperature between 10 and 30 rain time point in the two groups （P 〉 0. 05 ）. After CPT, the fingers skin temperature of VWF group was lower than that of control group at 5 min time point （ P 〈 0. 05 ）, but there were no statistically significant differences on fingers skin temperature of other time points between the two groups （ P 〉 0. 05 ）. In both groups, the finger skin temperature at 0 min time point after CPT were lower than other time points in the same group （P 〈 0. 05 ）, and the finger skin temperature increased with time （P 〈 0. 01 ）. However, the finger skin temperature at 30 rain after CPT did not restore to that at 30 rain time point of pre-CPT. Except the VWF group, the abnormal rewarming temperature at 5 rain time point after CPT of left index finger, the right index finger and the right ring finger were higher than that of the control group （72. 6% vs 56. 4%, 75.3% vs 57.6% , 86. 3% vs 65.1%, P 〈 0. 05 ） , hut there were no statistically significant differences on the abnormal rewarming temperature at 10, 30 rain time points of the six fingers in the two groups （P 〉 0. 05 ）. There were no statistically significant differences on the detection rate of abnormal rewarming temperature between left index finger and the right index finger, or the right index finger and the right ring finger in the VWF group （72.6% vs75.3%,75.3% vs86.3%,P〉0. 05）. Conclusion WhenCPT （10 ℃, 10 min） was performed in workers engaged in hand arm vibration operation, it is recommended to measure the finger skin temperature of index finger, and adaptation time before CPT can be adjusted to 10 min.