膨润土粉尘所致职业性尘肺病2例报道

Bentonite dust-induced occupational pneumoconiosis: a report of 2 cases

目的分析膨润土粉尘所致职业性尘肺病资料。方法回顾性分析2例膨润土粉尘所致职业性尘肺病病例的资料。结果 2例病例均有明确的接触膨润土粉尘职业史,病例1接触14年,病例2接触7年。2例病例的X射线胸片均表现为双肺弥漫性粟粒状密度增高影改变。病例1小阴影总体密集度2级,分布在5个肺区;病例2小阴影总体密集度2级,分布在4个肺区。病例1肺功能检查结果显示:用力肺活量(FVC)为81.4%,第一秒用力呼出量(FEV_1)为76.8%,第一秒用力呼气容积占用力肺活量比值(FEV_1/FVC)为74.4%,轻度肺通气功能损伤;病例2肺功能检查结果显示:FVC为84.0%,FEV_1为90.0%,FEV_1/FVC为93.0%,肺通气功能尚在正常范围。病例1诊断为职业性其他尘肺贰期(膨润土);病例2诊断为职业性其他尘肺壹期(膨润土)。结论膨润土粉尘所致职业性尘肺病临床症状、体征不明显;其诊断主要以X射线胸片为依据。

Objective To analyze the data of occupational pneumoconiosis caused by bentonite dust. Methods The data of 2 cases of occupational pneumoconiosis caused by bentonite dust was retrospectively analyzed. Results Both 2 cases had a clear history of occupational exposure to bentonite dust. Case 1 has a 14 years and case 2 has 7 years of bentonite exposure history. The radiographic examination of chest X-ray in both cases showed diffuse miliary nodules with high density in both lungs. The small opacity total profusion of chest X-ray images in both cases belong to category 2. The small opacity of lung in case 1 distributed in 5 areas,while case 2 distributed in 4 areas. The pulmonary function test for case 1 showed that the forced vital capacity（ FVC） was 81. 4%,the first second forced expiratory volume（ FEV_1） was 76. 8%and FEV_1/FVC was 74. 4%,mild pulmonary ventilation damage; lung function test results for case 2 showed： FVC was84. 0%,FEV_1 was 90. 0%,FEV_1/FVC was 93. 0%,pulmonary ventilation function was in the normal range. Case 1 was diagnosed as occupational pneumoconiosis stage Ⅱ（ bentonite）; Case 2 was diagnosed as occupational pneumoconiosis stageⅠ（ bentonite）. Conclusion The clinical symptoms and signs of occupational pneumoconiosis caused by bentonite dust are not obvious. Its diagnosis is mainly based on X-ray chest radiograph.