锡冶炼工尘肺病患者胸部影像学改变动态观察

发布时间：2018-05-02 10:16

本文选题：锡冶炼工 + 尘肺病　；参考：《中国职业医学》2017年05期

【摘要】：目的观察锡冶炼工尘肺病患者胸部影像学改变和转归情况。方法对10例锡冶炼工尘肺病病例进行胸部X射线和电子计算机断层扫描(CT)摄影及动态观察,分析其肺部影像学特点和转归情况。结果 10例锡冶炼工尘肺病患者的临床症状轻微,未见合并肺结核,肺通气功能改变不明显。诊断时X射线高千伏胸片结果显示:两肺小阴影形态以圆形为主,多分布在双肺中上肺区;多数病例肺纹理扭曲、变形或增多、模糊,肺门影增大增粗,淋巴结点状钙化,个别状如蛋壳,未见胸膜改变和肺气肿改变;5~10年的动态观察除1例患者小阴影增多外,其余均未见明显改变。2011年胸部CT检查可见2~5 mm的结节状影;其中,7例患者小结节从两上肺叶均匀分布至中叶、两肺下叶背段,下叶基底段病变减少;病变呈弥漫分布全肺叶,且胸膜下有小结节者3例;小叶间隔不同程度增厚5例;有小叶中心型或间隔旁肺气肿4例;其中1例有肺大泡形成。10例患者2016年胸部CT检查结果与2011年比较,弥漫性肺结节增多2例,小叶间隔增厚明显3例,肺气肿有进展2例。结论锡冶炼工尘肺病患者肺部小阴影经5~10年的X射线动态观察未见明显吸收,且病变有进展。CT检查有助于对锡冶炼工尘肺病进行追踪观察。
[Abstract]:Objective to observe the imaging changes and prognosis of pneumoconiosis in tin smelting workers. Methods 10 cases of pneumoconiosis of tin smelting workers were studied by chest X-ray and computed tomography (CT). The imaging features and prognosis of the lung were analyzed. Results the clinical symptoms of 10 patients with tin smelter pneumoconiosis were mild, no pulmonary tuberculosis was found, and the pulmonary ventilation function was not obvious. The results of X-ray high kilovolt chest radiographs showed that the small shadows of the two lungs were mainly circular in shape, mostly distributed in the upper and middle lung areas of both lungs, and in most cases, the lung was distorted, distorted or increased, blurred, the hilar shadow enlarged and thickened, and the lymph nodes were dotted with calcification. There were no pleural changes and emphysema changes in 5 ~ 10 years. Except for one patient with increased small shadow, there were no obvious changes in the other cases. In 2011, 2 ~ 5 mm nodular shadow could be seen on chest CT examination. In 7 cases, the nodules were evenly distributed from the upper lobes to the middle lobes, the dorsal segments of the lower lobes decreased, the lesions distributed diffusely throughout the lungs and there were small nodules under the pleura in 3 cases, and the interlobular septum thickened in 5 cases. There were 4 cases of central lobular emphysema or paracentricular emphysema, of which 1 case had alveolus formation and 10 cases had pulmonary bullae formation. Compared with 2011, 2 cases had diffuse pulmonary nodules, 3 cases had thickening interlobular septum, and 2 cases had emphysema. Conclusion the small shadow of lung in patients with pneumoconiosis of tin smelting workers has not been absorbed obviously by X-ray dynamic observation for 5 ~ 10 years, and CT examination is helpful for tracing and observation of pneumoconiosis in tin smelters.
【作者单位】：广西壮族自治区职业病防治研究院;
【基金】：公益性卫生行业科研专项基金(201402021)
【分类号】：R135.2

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