摘要
目的探讨甘肃省白银地区砂金矿工人肺纤维化形成原因，为防治提供科学依据。方法选取2003-2012年在我院临床确诊为肺纤维化的20例住院砂金矿工人进行临床特点与职业场所卫生状况相关性探讨。结果20例患者来自7家不同矿井，但职业场所卫生状况相似，均为自私营企业，普遍存在乱采滥挖现象，主要采用打竖井和打隆道的方式开矿。均使用柴油机作为动力，工作过程中矿井内烟雾、粉尘浓度很高，站在几米以外的人无法看见，检测了职业场所二氧化硫（SO2）、二氧化氮（NO2）、总悬浮颗粒物（TSP）和可吸人颗粒物（PM10）浓度，均超过国家制定标准。20例患者均有明显的呼吸系统症状，主要表现为咳嗽、咳痰、胸闷、胸痛、进行性呼吸困难、乏力等。体征有低氧血症、杵状指、爆裂音（velero啰音）等。胸片表现：两肺尖至肺底为不对称性、弥漫性、斑片状、云雾状模糊的实变影，以中上肺显著。肺的内、中、外带均被病变累及。病灶互相融合呈磨玻璃样改变，在阴影间可见广泛的粗细网状影和纤维索条影。部分患者合并有气胸。结论白银地区砂金矿工人接触粉尘中含有柴油机尾气烟雾，游离二氧化硅等，吸入高浓度柴油机尾气烟雾是引起肺纤维化的主要原因。
Objective To explore the cause of pulmonary fibrosis of workers who laboured in placer gold mine in Baiyin region of Gansu province in order to provide the scientific basis for prevention and treatment. Methods The correlation between clinical characteristics and health status of workplace of 20 hospitalized placer gold mine workers with pulmonary fibrosis diagnosed in our hospital from 2003 to 2012 were explored. Results Although 20 patients came from seven different mines, their health status of workplace were similar. These mines belonged to private enterprise, and existed widely the unchecked excavation, used mainly drilling shaft and drilling long way to mine, and used diesel engine as power. The concentration of smoke and dust in mines were very heavy during the mining process that people stood a few meters away could not been seen. The concentration of sulphur dioxide（SO2）, nitrogen dioxide（NO2）, total suspended particle（TSP） and particulate matter（PM10） at the workplace exceeded the national standards. Twenty patients had obvious respiratory symptoms, main symptoms were cough, sputum, chest tightness, chest pain, progressive dyspnea, fatigue, etc. The signs were hypoxemia, clubbing, crackles（velcro rale）, etc. The chest X-ray showed that there were asymmetric, diffuse, patchy, cloud-like fuzzy shadow in two lungs from apex of lung to base of lung, particularly significant in middle and upper lung; The lesions involved in the inner, middle and outer lung. The merging lesions showed the ground-glass-like changes, and extensive thick and thin reticular shadow and fibre ropes shadow were seen in the shadows. Part patients complicated with pneumatothorax. Conclusion The dust touched by workers who laboured in placer gold mine in Baiyin region of Gansu province contain diesel exhaust smoke and crystalline silica,etc. The main cause of pulmonary fibrosis of placer gold mine workers may be that the patients have inhaled high concentration of diesel exhaust smoke.
出处
《中国医药科学》
2013年第20期182-184,共3页
China Medicine And Pharmacy
关键词
砂金矿工人
肺纤维化
柴油机尾气
Placer gold mine workers
Pulmonary fibrosis
Diesel exhaust
