摘要
目的了解某钢铁企业尘肺病患者的流行病学特征和临床特征，为制定尘肺防治对策提供科学依据。方法以住院病例资料为依据，回顾性调查2007—2011年人住该企业职业病医院的652例尘肺病患者。结果矽肺患者占全部病例的98．8％，以尘肺壹期为主。吸烟人数占全部病例的25．9％，吸烟者中尘肺叁期病例所占比例最高，为60．4％。20世纪50年代开始接尘的病例居多，占73．2％；患者接尘工龄以21～30a的居多，占全部病例的36．7％。尘肺病例主要分布在采选矿等作业岗位，共占35．0％。尘肺病例的咳嗽、咳痰、气短，心悸等症状随尘肺期别的升高出现上升趋势，各期别间比较，差异均有统计学意义（P〈0．05）。比较各期别间并发结核病、肺气肿、肺心病的比例，差异有统计学意义（P〈0．05）。5年内尘肺患者住院总费用逐年增加，人均治疗费和人均药费增加明显。结论采选矿、耐火材料、修筑炉等岗位应该作为该企业粉尘危害的关键控制点，重点加强这些岗位的防护，减少岗位粉尘对工人的健康危害；提倡尘肺患者戒烟，延缓尘肺病的进展速度；建立规范的尘肺病住院患者诊疗流程，以提高尘肺患者的临床治疗效果，同时降低医疗费用。
Objective To provide scientific evidence for prevention and cure of pneumoconiosis through analysing the epidemiological and clinical features of pneumoconiosis patients in an Iron and Steel Enterprises. Methods Retrospective study was employed to investigate pneumoconiosis patients from the hospital of occupational diseases in the company from January 2005 to December 2011. Results 98.77% of the case was sillicosis patients, and most of them were in the first stage of pneumosilicosis. 25.92% of the patients smoke cigarette. The largest percentage of the smoking was appeared in the third stage of pneumosilicosis（60.41%）. 73.06% of the case began to be exposed to dust in 1950s. Most of the pneumoconiosis patients had worked with mining and dressing （34. 97%）. Higher percentage of the patients had symptoms such as cough, expectoration, cardiopalmus as the pathogenetic condition developing. The symptoms, complications and functional parameters of the lung among the patients in each stages of pneumosilicosis were significantly different（P〈0. 05）. The total cost and the direct cost from medical care of patients in hospital were increased with years. Conclusions The positions of mining and processing, refractories, furnace repair should be critical control points of dust hazard in the enterprise, and the protection of these positions should be strengthened in order to reduce job dust hazards to workers health. Smoking cessation in the patients with pneumoconiosis should be promoted in order to slow progress of pneumoconiosis; Specification treatment processes for pneumoconiosis inpatient should be established to improve clinical outcomes in the patients with pneumoconiosis and to reduce the health care costs.
出处
《工业卫生与职业病》
CAS
CSCD
北大核心
2013年第6期340-343,共4页
Industrial Health and Occupational Diseases
关键词
钢铁企业
尘肺病
病例分析
Iron and steel enterprise, Pneumoconiosis, Case analysis
