精细打磨工人甲襞微循环特点分析

Characteristics of nailfold capillaroscopy in fine sanding workers

目的分析手传振动作业对精细打磨工人手指甲襞微循环的影响。方法采用判断抽样方法,选择广东省某高尔夫球具厂从事手传振动作业的57名精细打磨工人为接振组,以30名无接触手传振动作业的工人为对照组。对2组工人进行甲襞微循环检查。结果接振组工人的管袢周围出血点检出率、异常管袢比例、管袢总宽均高于对照组[43.9%vs 13.3%,(56.6±20.9)%vs(41.2±14.5)%,(44.7±4.9)vs(42.4±4.9)μm,P<0.05],管袢密度、管袢长度和输出支管径均低于对照组[(7.7±1.0)vs(8.8±1.0)个/mm,(185.1±33.9)vs(205.6±23.2)μm,(18.3±1.9)vs(19.6±2.6)μm,P<0.05];但2组工人袢顶直径和输入支管径分别比较,差异均无统计学意义(P>0.05)。接振组工人左手异常管袢比例低于右手[(53.1±20.6)%vs(61.5±24.2)%,P<0.01],管袢长度长于右手[(187.2±33.5)vs(179.4±35.4)μm,P<0.05];但其左、右手的管袢密度、管袢总宽、袢顶直径、输入支管径和输出支管径分别比较,差异均无统计学意义(P>0.05)。结论手传振动接触可导致精细打磨工人的手指甲襞管袢密度减少,管袢长度变短,管袢总体变宽,异常管袢比例和管袢周围出血增加。甲襞微循环检查可作为早期发现手传振动所致血管损伤的辅助检查手段。

Objective To analyze the effects of hand-transmitted vibration operation on nailfold capillaroscopy( NFC) in fine sanding workers. Methods A total of 57 fine sanding workers of one golf ball production enterprise in Guangdong Province were selected as vibration exposure group and 30 workers without exposure to hand-transmitted vibration as control group by a judgement sampling method. NFC examination was carried out in workers of these two groups. Results The capillary haemorrhage detection rates,percentage of abnormal capillary loops and total capillary width in the vibration exposure group were higher than that in the control group [43. 9% vs 13. 3%,( 56. 6 ± 20. 9)% vs( 41. 2 ± 14. 5)%,( 44. 7 ± 4. 9) vs( 42. 4 ± 4. 9)μm,P < 0. 05]. The capillary density,capillary length and branch diameter in the vibration exposure group were lower than that in the control group [( 7. 7 ± 1. 0) vs( 8. 8 ± 1. 0) per mm,( 185. 1 ± 33. 9) vs( 205. 6 ± 23. 2)μm,( 18. 3 ± 1. 9) vs( 19. 6 ± 2. 6)μm,P < 0. 05]. No significant difference was found in the diameter of apical part and branch of capillaries between the two groups( P > 0. 05). In the vibration exposure group,the percentage of abnormal capillary loops in the left hand was lower than that in the right hand [( 53. 1 ± 20. 6)% vs( 61. 5 ±24. 2)%,P < 0. 01],the capillary length in the left hand of vibration exposure group was longer than that in the right hand [( 187. 2 ± 33. 5) vs( 179. 4 ± 35. 4)μm,P < 0. 05]. No significant difference was found in the capillary density,total capillary width,apical part diameter,output branch diameter and input branch diameter between two hands in the vibration exposure group( P > 0. 05). Conclusion The hand-transmitted vibration can lower the nailfold capillary density,shorten and widen capillary loops, increase percentage of abnormal capillary loops and induce capillary haemorrhage. NFC could be used to assist early detection of microvascular damage induced by hand-transmitted vibration.