广西省粉尘作业者职业健康检查尘肺病漏诊分析

发布时间：2017-12-27 20:00

本文关键词：广西省粉尘作业者职业健康检查尘肺病漏诊分析　出处：《环境与职业医学》2015年04期 　论文类型：期刊论文

【摘要】：[目的]了解广西省粉尘作业者职业健康检查尘肺病诊断4个环节的漏诊情况,为改善和提高广西职业健康检查尘肺病诊断质量提供科学依据。[方法]将尘肺病诊断分为非正式尘肺病初诊、进入尘肺病复诊、申请尘肺病诊断、正式尘肺病诊断4个环节。从广西省8市2011年至2013年进行过粉尘作业职业健康检查的企业,整群抽取23家共计1 265名受检者,由具有尘肺病诊断资质的专业人员按尘肺病诊断标准集体读片,确定非正式尘肺初诊病例。查阅其职业健康监护档案资料及市级、自治区级尘肺病诊断、住院档案资料。统计粉尘作业者职业健康检查尘肺病诊断4个环节漏诊率。比较不同诊断机构、企业属性、岗前/岗中、检查年份进入尘肺病复诊环节的漏诊率。[结果]147例非正式尘肺初诊病例,35例取得尘肺病诊断证明书,广西省粉尘作业者职业健康检查尘肺病漏诊率为76.2%(112/147)。其中职业健康检查非正式尘肺病初诊环节漏诊率0%(0/147),进入尘肺病复诊环节漏诊率59.9%(88/147),申请尘肺病诊断环节漏诊率37.3%(22/59),正式诊断环节漏诊率5.4%(2/37)。不同职业健康检查机构、企业属性进入复诊环节漏诊率差异均有统计学意义(χ2=60.54,P0.01)(χ2=112.82,P0.01)。[结论]广西粉尘作业者职业健康检查尘肺病漏诊率较高,漏诊主要发生在进入尘肺病复诊和申请尘肺病诊断环节。应加强对尘肺病检查诊断机构及受检企业尘肺病诊断的管理。
[Abstract]:[Objective] to understand the Guangxi province occupation health inspection workers dust pneumoconiosis diagnosis 4 aspects of the missed diagnosis, and provide scientific basis for improving and enhancing the Guangxi occupation health examination quality diagnosis of pneumoconiosis. [Methods] the diagnosis of pneumoconiosis was divided into 4 steps: first diagnosis of unofficial pneumoconiosis, rediagnosis of pneumoconiosis, diagnosis of pneumoconiosis, and diagnosis of formal pneumoconiosis. From the 8 cities of Guangxi Province, from 2011 to 2013, a total of 1265 subjects were sampled from 23 families in the dust occupational occupational health examination. A group of professionals diagnosed with pneumoconiosis diagnosed the pneumoconiosis according to the diagnostic criteria of pneumoconiosis. Access to their occupational health monitoring files and the diagnosis of pneumoconiosis and hospitalization files at the municipal and autonomous regions. Occupation Health Examination Statistics of dust exposed workers with pneumoconiosis diagnosis 4 links misdiagnosis rate. The rate of missed diagnosis was compared between different diagnostic institutions, enterprise attributes, pre job / post and examination years. [results]147 cases 35 cases of newly diagnosed cases of informal pneumoconiosis, obtain certificate of diagnosis of pneumoconiosis, rate of missed diagnosis in Guangxi province occupation health examination in dust exposed workers pneumoconiosis was 76.2% (112/147). Among them, the rate of missed diagnosis of occupational pneumoconiosis was 0% (0/147), and the missed diagnosis rate of pneumoconiosis was 59.9% (88/147). The missed diagnosis rate of pneumoconiosis was 37.3% (22/59), and the missed diagnosis rate of formal diagnosis was 5.4% (2/37). There was significant difference in the rate of missed diagnosis between different occupational health examination institutions and enterprise attributes (x 2=60.54, P0.01) (x 2=112.82, P0.01). Higher missed diagnosis rate of Guangxi occupation health examination in dust exposed workers pneumoconiosis [Conclusion], misdiagnosis occurred mainly in the entry of pneumoconiosis pneumoconiosis diagnosis and application for referral link. The diagnosis of pneumoconiosis examination and diagnosis should be strengthened and the diagnosis of pneumoconiosis should be managed.
【作者单位】：广西壮族自治区职业病防治研究院肺功能室;广西壮族自治区职业病防治研究院专家室;广西壮族自治区职业病防治研究院质控科;广西壮族自治区职业病防治研究院医保办;广西壮族自治区职业病防治研究院尘肺一病区;广西壮族自治区职业病防治研究院职业健康体检部;广西壮族自治区职业病防治研究院科教科;
【基金】：广西医疗卫生重点科研课题(编号:重2012044)
【分类号】：R135.2
【正文快照】： 粉尘作业人员职业健康检查的目的在于及时发现尘肺病患者和粉尘作业禁忌症者。此类职业健康检查直接影响尘肺病的诊断质量及尘肺病二级预防的实施效果,直接关系尘肺病人补偿政策的落实和尘肺病人的待遇。我国大陆现阶段尘肺病的诊断执行由有尘肺病诊断资质的机构组织3名以上有

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