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选择2003年1月至2006年6月,因生产硅砖而致矽肺且在我院确诊后每年至少1次返院系统复查和再次住院晋期的65例患者,进行3～6年的动态观察。患者来自2家硅砖耐火厂,均为原料粉碎工,接触的粉尘游离二氧化硅含量为96%～98%,2家企业共37个检测点粉尘浓度为20.03～46.02mg/m2,超标率92.50%。65例患者中初次被确诊为Ⅰ期矽肺32例(含I+期23例)、Ⅱ期26例、Ⅲ期7例。3～6年的动态观察发现,65例中发生晋期的19例,晋期率29.23%,其中Ⅰ期晋期率34.38%、Ⅱ期晋期率23.08%、Ⅲ期晋Ⅲ+期者28.57%。晋期者初诊越期诊断明显,占86.15%,并发症多且反复出现。晋期者X线表现以圆形小阴影q/q为主,阴影密集度高,分布肺区范围广,累及5个肺区以上者占84.21%。二次晋期者均并发肺结核。说明硅砖原料经粉碎及球磨后分散度大,致病性强,矽肺病情重,发生矽肺病后病情进展迅速,早期防治极为重要。
Select January 2003 to June 2006, due to the production of silicosis and silicosis and confirmed in our hospital at least once a year to review the hospital system and re-hospitalization of 65 patients Jin, 3 to 6 years of dynamic observation . Patients were from two silica refractory plants, both raw material crushing workers, the contact dust free silica content of 96% to 98%, two companies a total of 37 test points dust concentration of 20.03 ~ 46.02mg / m2, exceeding the rate 92.50%. Among the 65 patients, 32 cases were diagnosed as stage I silicosis (including 23 cases of stage I), 26 cases of stage II and 7 cases of stage III. Three to six years of dynamic observation found that 19 cases occurred in 65 cases of Jin, Jin period rate of 29.23%, of which 34.38% of the first phase of Jin, 23.08% of the second phase of Jin, Ⅲ Ⅲ period of 28.57 %. The first diagnosis of Jin overdiagnosis was obvious, accounting for 86.15%, many complications and recurring. Jin X-ray showed a small round shadow q / q-based, high-intensity shadows, a wide range of distribution of lung area, involving more than 5 lung area accounted for 84.21%. Secondary Jin are complicated by pulmonary tuberculosis. Description of raw materials after crushing and ball milling silicon dispersion, pathogenicity, silicosis, serious disease progression after silicosis, early prevention and treatment is extremely important.