鞍钢2007-2011年652例尘肺病病例分析

发布时间：2018-02-25 03:07

  本文关键词： 鞍钢 尘肺病 病例分析　出处：《吉林大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：本研究旨在了解鞍钢尘肺病患者的流行病学特征和临床特征，为更好的贯彻新职业病防治法、制定尘肺防治对策提供科学依据。同时对住院发生的费用情况加以分析，为工伤保险提供数据上的支持。 方法：以出院病例为依据，回顾性调查自2007年1月至2011年12月期间入住鞍钢职业病医院的尘肺病患者，重复住院的患者以首次住院信息为准。记录患者年龄、性别、尘肺期别、厂矿、工种、接尘史、诊断年限、尘肺晋级年限、临床症状和体征等信息，计数资料用χ2检验、计量资料用秩和检验、方差分析和q检验统计方法进行相应的分析。 结果：①一般情况：本研究中，病例的平均年龄73.6岁，大于70岁年龄组人数最多，占全部病例的63.34%。矽肺患者占全部病例的98.77%，以尘肺壹期为主。吸烟人数占全部病例的25.92%，尘肺叁期病例中吸烟人数所占比例最高，占60.41%。吸烟者人数在尘肺各期别之间差异有统计学学意义（P0.001）。②发病特征20世纪50年代开始接尘的病例居多，占73.16%；患者接尘工龄以21~30年的居多，占全部病例的36.66%。尘肺病例主要分布在采、选矿行业，共占34.97%。不同作业工人尘肺的发病工龄和发病年龄经统计学分析无差异（P＞0.05）。各诊断年代之间病例的平均发病工龄和平均发病年龄差异均有显著性（P0.001）。③临床特征.尘肺病例的咳嗽、咳痰、气短，心悸等症状随尘肺期别的提高出现的比例有所提高，各期别间比较，差异均有统计学意义（P＜0.05）。比较各期别结核病、肺气肿、肺心病的比例，差异有统计学意义（P＜0.05）。FVC、FEV1、FEV1/FVC、MVV等肺功能指标测定值在三个期别间比较，差异均有有统计学意义(P0.001)。④本组病例中住院总费用逐年增加，人均治疗费、人均药费增加明显。 结论：鞍钢现存尘肺病例以矽肺为主，，70岁以上老人居多，男性多于女性。以50年代开始接尘，接尘工龄为21~30年的病例居多。尘肺病例大多分布在采选矿、耐火材料等6个行业。尘肺病以壹期为主要表现，壹期晋贰期的晋期年限最短，尘肺晋期年限随发病年龄的上升而缩短。随着诊断年代的推移，尘肺发病年龄明显增大、接尘工龄显著延长。尘肺病的咳嗽、咳痰、等症状随尘肺期别的提高更加明显，随着尘肺期别的进展，肺功能指标逐渐下降的趋势。尘肺病并发症常见，吸烟对尘肺病情有影响。尘肺病住院费用逐年上涨，企业及社会医疗保险部门负担沉重。
[Abstract]:Objective: to understand the epidemiological and clinical characteristics of patients with pneumoconiosis in Anshan Iron and Steel Co. Provide data support for injury insurance. Methods: based on the discharged cases, the pneumoconiosis patients who were admitted to Angang Occupational Disease Hospital from January 2007 to December 2011 were retrospectively investigated. The information of pneumoconiosis stage, factory and mine, type of work, history of dust exposure, years of diagnosis, years of promotion of pneumoconiosis, clinical symptoms and signs were analyzed by 蠂 2 test, rank sum test, variance analysis and Q test. Results: in this study, the average age of the cases was 73.6 years, which was the highest in the age group more than 70 years old. Silicosis accounted for 98.77% of all cases, mainly in stage one of pneumoconiosis. The number of smokers accounted for 25.92% of all cases, and the proportion of smokers in the third stage of pneumoconiosis was the highest. The number of smokers had statistical significance among the different stages of pneumoconiosis. In 1950s, the majority of the patients were exposed to dust (73.16%), and the majority of the patients were exposed to dust for 21 ~ 30 years. The cases of pneumoconiosis are mainly distributed in the mining and mineral processing industry. There was no significant difference in the length of work and age of pneumoconiosis in different workers (P > 0.05). There were significant differences in the mean working age and age of pneumoconiosis between different diagnostic years. The proportion of symptoms such as expectoration, shortness of breath and palpitation increased with the increase of pneumoconiosis, and the difference was statistically significant (P < 0.05). The proportion of tuberculosis, emphysema and cor pulmonale in each stage was compared. The difference was statistically significant (P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, respectively). Conclusion: the majority of the existing pneumoconiosis cases in Anshan Iron and Steel Company are silicosis over 70 years old, male is more than female. Since 50s, dust exposure has been more common, and the dust exposure period is 21 ~ 30 years. The pneumoconiosis cases are mostly distributed in mining and mining. Six industries, such as refractories. Pneumoconiosis is mainly manifested in one stage, the Jin period of the first Jin period is the shortest, and the Jin period of pneumoconiosis is shortened with the increase of onset age. With the passage of diagnostic age, the age of pneumoconiosis onset increases significantly. The symptoms of pneumoconiosis such as cough, expectoration, and other symptoms were more obvious with the increase of pneumoconiosis stage, and with the progression of pneumoconiosis stage, the pulmonary function index decreased gradually. The complications of pneumoconiosis were common. Smoking has an effect on pneumoconiosis. The hospitalization cost of pneumoconiosis is increasing year by year, and the burden of enterprise and social medical insurance department is heavy.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R135.2

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