【摘要】 目的探讨农民石工肺患者的临床特征及气管镜下表现。方法分析2012-03/2015-07期间入住达州市中心医院的农民石工和煤矿工患者的胸部CT检查和支气管镜检查结果及临床资料。结果共计133例农民石工及煤矿工患者,全部系男性,年龄30~80岁,平均年龄60.55岁,其中农民石工71例,从事采煤的农民或矿工62例,农民石工患者的平均年龄较煤矿工患者小4.68岁,两组患者胸部CT改变除弥漫小结节外,其余观察项差异无统计学意义(P>0.05),农民石工患者气管镜下发现新生物30例(42.25%),明显多于煤矿工患者(13例,20.97%,P<0.05)。农民石工患者气管变形狭窄及痰末沉着的例数少于煤矿工患者(P<0.05)。农民石工患者胸部CT符合矽肺改变者占53.52%,与煤矿工尘肺(64.52%)相比无显著差异(P>0.05)。综合病史、胸部CT改变和气管镜检等资料,农民石工患者诊断肺癌的比例(38.03%)高于煤矿工患者(19.35%)(P<0.05),而煤矿工患者的慢性阻塞性肺疾病发生率(45.15%)显著高于农民石工患者(21.13%)(P<0.05)。结论农民石工发生尘肺和肺结核的比率与煤矿工差异无统计学意义,而农民石工患者的肺癌发生率高于煤工患者,煤矿工患慢阻肺者多于农民石工,二者气管镜下的表现各有特点。农民石工气道内易见新生物,而煤矿工患者气道内碳末沉着及气道狭窄多见,这些差异可能与不同粉尘原致病机理不同有关。更多还原

【Abstract】 Objective To approach the clinical features and analyze bronchoscopic findings in patients with pulmonary diseases of farmer stonemason. Methods Chest CT manifestations,bronchoscopic findings,related examinations and clinical data in hospitalized patients of our hospital from March 2012 to July 2015 were analyzed and compared between farmer stonemasons( FS) and coal miners( CM). Results All patients had 133 cases,they were all male,aged 30-80 years old,their average age were 60. 55 years old,among them were 71 FS cases,and 62 CM cases,the average age of FS were 4. 68 years younger than CM,the neoplasm under bronchoscopy were found in patients with FS about 30 cases( 42. 25%),were increased distinctly than CM( 13 cases,20. 97%,P < 0. 05). The number of cases with bronchial distortion,narrow and carbon-powder in patients of FS were significantly lower than CM( P < 0. 05). The changes of thoracic CT fitting silicosis in patients of FS were 53. 52%,there was no significant difference than CM pneumoconiosis( 64. 52%). Integrated history,chest CT and bronchoscopic examination and clinical data; the proportion of diagnosed lung cancer in patients of FS( 38. 03%) was significantly higher than CM( 19. 35%,P < 0. 05). But incidence of chronic obstructive pulmonary disease( COPD) in patients with CM( 45. 15%) significantly higher than FS( 21. 13%,P < 0. 05). Conclusion There is no significantly difference in pulmonary TB and pneumoconiosis between FS and CM. Incidence of lung cancer in FS is higher than CM,but COPD of CM is significantly higher than FS.It’ s features under bronchoscopy between AS and CM are that the neoplasm in patients with FS is seed easily,but carbon-powder and airway stenosis in patients with CM is more to see,this differences were correlated with different pathogenesis of different dust inhaled by FS and CM.更多还原