Radical Vietnam period-style 28 cases of pneumoconiosis clinical and imaging analysis

[Abstract] Objective of the aggressive type of "more period style" pneumoconiosis of clinical performance and image science characteristic method using retrospective analysis method analysis of 28 cases by occupational disease diagnostic group diagnosed as pneumoconiosis Ⅲ ​​period of clinical and cases of data results of 28 cases of pneumoconiosis Ⅲ lives are complicated by bronchitis and mild emphysema, including nine cases and tuberculosis, the other two patients with active tuberculosis. lung lesions (8 cases of large shadow in the right lung, right on the lung in 12 cases left 5 cases of lung three cases, the left upper lung Conclusion 28 cases of pneumoconiosis patients according to reliable occupational dust exposure history, clinical manifestations, imaging technology quality standards posteroanterior chest radiograph, and with reference to the necessary dynamic observation data and units pneumoconiosis epidemiology survey the situation, and then the diagnosis of occupational diseases group pneumoconiosis diagnosis based on national standards, make the pneumoconiosis diagnosis and staging.

[Words] pneumoconiosis large shadow of the more period

Pneumoconiosis is caused by long-term inhalation of a certain concentration of productive dust diffuse lung fibrosis an occupational disease [1] which in China is currently the more common and serious harm, especially pneumoconiosis becomes late, many small dust Results Festival each other gradually fused into a dense block or round shadows, uncommon pathology, and clinical observation. early pneumoconiosis was rapidly progressive type "the more the term" integration circular shadow and rare. radiological signs exactly like lung cancer and tuberculoma, thus easily lead to clinically misdiagnosed. deepen understanding of time to determine the of pneumoconiosis diagnosis and staging of such lesions and avoid misdiagnosis, now met in practical work over the years to provide clinical reference, collected 28 cases of the more period style pneumoconiosis analyzed as follows.

1 objects and methods

28 patients were male, aged 24 to 46 years, with an average age of 31.5 years, exposed to dust 3 to 16.5 years, 7.5 years average exposed to dust trades distribution: excavation work in 11 cases, seven cases of the drilling work, pneumatic drill workers cases, four cases of hand hammer work .28 cases of pneumoconiosis patients annually also once connected the dust physical examination and chest X-ray imaging intake technical quality qualified clinical manifestations: this group of patients showed respiratory symptoms, cough, cough, shortness of breath, sometimes fatigue, mild chest pain, chest tightness. lung breath sounds rough, weakened.

2 Results

28 cases of pneumoconiosis patients with bronchitis and emphysema. Pulmonary function test: 28 cases in 21 patients with mild hypothyroidism, the other 7 patients with moderate loss of field space dust free silica content in more than 41% (national regulations containing more than 10% of free silica dust health standards 1mg/m3 [7] .28 patients with radiographic chest X-ray showed a large shadow round of round shapes fusion diameter: 20 × 18 mm 18 cases, 25 × 27 mm, 33 x 31 mm 4 large shadow surrounding clear, homogeneous, central no punctate calcification. around Star stove .28 cases in eight cases in the right lung, and 12 cases in the right upper lung three cases in left in the lungs, the five cases in the left upper lung. connected with ipsilateral hilar see all round class round shadow also a little cable strip shadows. 9 cases in 28 cases and tuberculosis two cases and active tuberculosis .28 cases of occupational disease diagnosis group (GBZ70-2002 by country pneumoconiosis diagnostic criteria diagnosis of pneumoconiosis stage Ⅲ [5.6]. discussion acute Links to free papers Download Center http://eng.hi138.com
3 silicosis occurred in contact with high silica content and also have a high concentration of dust-exposed workers, and more common in the mining of adverse ventilation and dust control measures, especially small and medium-sized enterprises, small private factories and mines [1]. cases of dust exposure clear history, workplaces excessive dust concentration (exceeding 13 times the free silica dust content of> = 41% but it is a rare aggressive type of by Ⅰ silicosis was "the more the term" rapid development stage Ⅲ fusion silicosis type of clinical performance is not very typical X-ray findings was when the the independent round classes the circular fusion lesions. development to late change routine when pneumoconiosis, during evolution by nodules shadow gradually formed fusion or subclasses round shadows, aggregation whitish area lesions first appeared, and then developed into the oval, spherical, disc-shaped or irregular-shaped shadow, etc. due to the fusion of the shadow appearing progressive, it is one important feature is its surroundings often accompanied emphysema with pneumoconiosis own law of development gradually form a typical fusion of the natural fusion As for the principle of it happening, there is no unified concept, generally: ① silicotic nodules increase in the number of volume increases, mutual fusion (2) enlargement of lymph nodes near the bronchial oppression belongs lung tissue caused atelectasis as a fusion based ③ addition to the above, the inflammation of the lung tissue invasion play a catalytic role in the formation of the large piece of connective tissue [12]. silicosis the speed of the onset of Jihuan and course, contact the silica content in the air (concentration, dispersion, labor, health conditions, as well as personal physiological conditions (including immune function is closely related to the general incidence of seniority in 3 to 5 years, or slightly longer the progression of the disease by stage Ⅰ to Ⅱ stage more than 5 to 8 years, such as the development stage Ⅲ may be 10 to 18 years, so that the incidence and progression of silicosis is slow in the case of no complications. majority of pathological symptoms and progression to late (Ⅲ period, the symptoms get worse, the loss of the ability to work, both in quiet and may also occur such as difficulty breathing, palpitations, cough and expectoration. rapid formation under the influence of other factors atypical fusion that probability Fusion, there may be a special X-ray findings. reasons for the formation of such a large shadow, some authors believe that tuberculosis infection is basic and only some of that with the TB infection, non-specific inflammation and atelectasis. well known that the lungs produce diffuse fibrosis, pulmonary blood flow and lymphatic circulation arrest, airway obstruction, resulting in disorders of the blood vessels and nerves nutrition, all of which is induced acute inflammation of the pathological basis [23]
The common characteristics of the 28 patients are in the development stage Ⅰ silicosis on the basis of radical integration around its X-ray findings showing round class circular shadow clear boundary formation drainage, and hilar no calcification in the middle, surrounded by sub stove, nor emphysema band, showed a trend of rapid development in the short term, it is also in clinical suspected tuberculoma or lung tumors were excluded after clinical identification or pathologically confirmed two possibilities. therefore, we think that the the round-class round silicosis change was aggressive type of fusion is not caused by tuberculosis infection, it can be some kind of acute and chronic inflammation, infection, local pathological basis of the formation of fusion, when infected factors failed to timely eliminate the direct cause of the rapid integration of class round small shadow, lungs silicon lesions is still at the development of its own laws, which constitute a contrast X-ray image is This shows that the non-specific inflammation of the infection is not be ignored. [12]
Rapidly progressive silicosis is more common in miners, average length of service of 4.5 years or less, and for the class round silicosis. Based interstitial silicosis not seen yet this group of patients are nodular silicosis, their factories and dust higher concentrations of dust only about 41% silica content. yet to be seen in the dust concentration and higher silica content in the factories and mines. visible, such lesions beyond the law of general silicosis fusion, is due to a large number of silica dust inhalation, in a shorter time within its suction is greater than the net dust discharge of the patient's physiological role is somehow involved in acute and chronic inflammation, formation of a special type. [4]
This article by the X-ray images of the 28 cases of rapidly progressive silicosis analysis, the more period-style "acute convergence shadows of the formation and rapid development of silicosis was discussed. The typical integration silicosis (natural fusion, generally depending on the disease itself the development of the law, while atypical fusion (probability fusion are mostly caused by different infectious factors. performance is not typical in the area of ​​clinical symptoms. simple silicosis Phase I, in a non-specific inflammation under the influence of a rapidly progressive fusion lesions, and can quickly develop into silicosis stage Ⅲ. [14]

References

[1] Li Dehong. Occupational diseases physician training materials, pneumoconiosis [M] Beijing: People's Daily Press, 2003:170 ~ 171
[2] Dong-Mei Su, Liang Hongli, Wang Jing, 32 cases of rapidly progressive silicosis clinical analysis [J] << Industrial Hygiene and Occupational Diseases >> 2003.29 (2:111 ~ 112

[3] Wu Enhui Medical Diagnostic Imaging [M], Beijing: People's Health Publishing House, 2008:531 ~ 538

[4] often Zhuping, Wang Hongchun, Yao Dancheng, .72 cases of acute silicosis and 13 cases of deaths in clinical and X-ray analysis [J] Chinese Journal of Industrial Medicine, 2005,18 (4

[5] GBZ70-2002, pneumoconiosis diagnostic criteria [S]


[6] ZHAO Jin-yuan clinical occupational medicine [M] .2 Beijing: Peking University Medical Press ,2010:191 of -194
[7] Lide Jie, Ning Yuhua. Determination of free silica dust method improved [J]. Journal of Industrial Hygiene and Occupational Diseases, 2006,24 (9:566-567 posted on the free papers Download Center http://www. hi138.com

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