【摘要】 目的观察氟中毒病区经过多年改水降氟后的防治效果,为今后防治工作提供可信的依据。方法选择实施改水多年的饮水型氟中毒历史重病区县盐湖区开展调查,按照分层整群抽样的方法抽取调查点,对每个调查点8岁~12岁儿童的氟斑牙及成人重度氟骨症患者患病情况进行调查,儿童氟斑牙检查采用氟斑牙诊断(WS/T208-2011),重度氟骨症患者检查按照氟骨症临床诊断标准(WS 192-2008)进行,水氟、尿氟含量分析用氟离子选择电极法。结果饮水型氟中毒病区采取改水降氟防治措施多年后,各类病区的水氟含量与改水前相比均明显下降(P<0.01),但部分病区水氟含量超过了国家控制标准。各类病区中儿童氟斑牙检出率均在40%以上,接近中等流行强度,调查未发现重度氟骨症患者。与改水前相比病情明显好转,尤其是重病区控制水平大部分已达到轻病区水平,检出率随病区严重程度增加而增高,中、重病区防治措施难度要大于轻病区。结论改水降氟是饮水型氟中毒病区的有效防治措施,今后在加大改水力度的同时,更重要是严把改水工程质量和管理,加强监测,提高防治效果。更多还原

【Abstract】 Objective To explore the preventive results of water-improving and defluoridation in endemic fluorosis areas after some years,and to provide scientific basis for formulating prevention and control strategies. Methods Yanhu County,the severe fluorosis region in Shanxi province,was selected as prevention and control measure of water-improving and defluoridation had been actualized for some years. The investigation points were selected by stratified and cluster sampling in the disease areas of water-improving and defluoridation. Dental fluorosis of 8~12 years old children and sufferers of serious skeletal fluorosis were examined in each point. Children’s dental fluorosis of was diagnosed by Diagnosis of dental fluorosis(WS/T208-2011). Sufferers of serious skeletal fluorosis were examined with"Diagnose Criteria of skeletal fluorosis(WS 192-2008)".The fluoride content of water and urine were determined by fluoride selective ion electrode. Results In every type disease areas the fluoride content of water was dropped significantly by water-improving defluoridation after some years(P<0.01). However,the fluoride content of water still above the national cotrol quality level in some endemic fluorosis areas of water-improving and defluoridation. In every type disease areas detectable rates of dental fluorosis in children were above 40% and were close to the middle prevalence. Sufferers of serious skeletal fluorosis were not found. The disease state of endemic fluorosis became better especially that the level of control in many severe fluorosis regions had already become slight fluorosis region. The detectable rates of dental fluorosis in children significantly varied with the serious of disease area,so the difficulty of prevention and control measures was greater in the middle and severe disease areas. Conclusions Improving water quality is an effective method for prevention and control in endemic fluorosis areas. It’s more important to assure the quality and management of the water-improving project when strengthening water-improving to raise the effect of prevention and control.更多还原