某铝厂职业性慢性氟中毒九例临床分析及随访观察

Clinical analysis and follow-up observation of nine cases of occupational chronic fluorosis in an aluminum factory

目的观察职业性慢性氟中毒病例的临床特点及调离氟作业岗位后患者病情改变情况。方法于2020年1月,收集并分析2010年1月至2020年1月某铝厂在我院诊断的职业性慢性氟中毒病例的临床资料及诊断后2年随访资料。结果9例患者均有四肢长骨及关节疼痛症状,骨骼X线检查出现氟骨症改变,尿氟升高,诊断为职业性慢性轻度氟中毒。2年后随访的6例患者中,2例症状及骨骼X线检查均有改善,3例症状有改善,但骨骼X线检查无明显变化,仅1例症状及骨骼X线检查均加重,考虑该结果与其调动后岗位仍接触氟化氢有关。结论骨骼X线检查改变为职业性慢性氟中毒的特征表现,脱离氟作业岗位后患者临床症状可有减轻,骨骼病变无活动性加重,部分患者骨骼病变有减轻趋势。

Objective To observe the clinical characteristics of occupational chronic fluorosis cases and follow up patients'condition changes after they have been transferred from fluoride work.Methods In January 2020,the clinical data of occupational chronic fluorosis cases diagnosed in our hospital and their corresponding two-year follow-up data were collected and analyzed.These cases happened in an aluminum factory between January 2010 to January 2020.Results Nine patients were diagnosed as occupational chronic mild fluorosis because of long bones and joints pain.Skeletal X-ray examination showed a result of skeletal fluorosis and increased urine fluoride.Among the six patients who have been followed up for two years,two of them showed improvements in both symptoms and skeletal X-ray examination results.Three patients'symptoms were alleviated,but their skeletal X-ray examination results showed no significant change.Besides them,the last patient's symptoms and skeletal X-ray examination results were aggravated,which was considered related to still exposed to hydrogen fluoride in new position.Conclusion Changes of skeletal X-ray examination are the characteristics of occupational chronic fluorosis.By leaving the fluoride position,patients'clinical symptoms can be alleviated,and their bone lesions are not aggravated or even show a trend of alleviating in some cases.