發(fā)布時間：2018-02-25 03:07

  本文關(guān)鍵詞： 鞍鋼 塵肺病 病例分析　出處：《吉林大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：本研究旨在了解鞍鋼塵肺病患者的流行病學(xué)特征和臨床特征，為更好的貫徹新職業(yè)病防治法、制定塵肺防治對策提供科學(xué)依據(jù)。同時對住院發(fā)生的費用情況加以分析，為工傷保險提供數(shù)據(jù)上的支持。 方法：以出院病例為依據(jù)，回顧性調(diào)查自2007年1月至2011年12月期間入住鞍鋼職業(yè)病醫(yī)院的塵肺病患者，重復(fù)住院的患者以首次住院信息為準。記錄患者年齡、性別、塵肺期別、廠礦、工種、接塵史、診斷年限、塵肺晉級年限、臨床癥狀和體征等信息，計數(shù)資料用χ2檢驗、計量資料用秩和檢驗、方差分析和q檢驗統(tǒng)計方法進行相應(yīng)的分析。 結(jié)果：①一般情況：本研究中，病例的平均年齡73.6歲，大于70歲年齡組人數(shù)最多，占全部病例的63.34%。矽肺患者占全部病例的98.77%，以塵肺壹期為主。吸煙人數(shù)占全部病例的25.92%，塵肺叁期病例中吸煙人數(shù)所占比例最高，占60.41%。吸煙者人數(shù)在塵肺各期別之間差異有統(tǒng)計學(xué)學(xué)意義（P0.001）。②發(fā)病特征20世紀50年代開始接塵的病例居多，占73.16%；患者接塵工齡以21~30年的居多，占全部病例的36.66%。塵肺病例主要分布在采、選礦行業(yè)，共占34.97%。不同作業(yè)工人塵肺的發(fā)病工齡和發(fā)病年齡經(jīng)統(tǒng)計學(xué)分析無差異（P＞0.05）。各診斷年代之間病例的平均發(fā)病工齡和平均發(fā)病年齡差異均有顯著性（P0.001）。③臨床特征.塵肺病例的咳嗽、咳痰、氣短，心悸等癥狀隨塵肺期別的提高出現(xiàn)的比例有所提高，各期別間比較，差異均有統(tǒng)計學(xué)意義（P＜0.05）。比較各期別結(jié)核病、肺氣腫、肺心病的比例，差異有統(tǒng)計學(xué)意義（P＜0.05）。FVC、FEV1、FEV1/FVC、MVV等肺功能指標測定值在三個期別間比較，差異均有有統(tǒng)計學(xué)意義(P0.001)。④本組病例中住院總費用逐年增加，人均治療費、人均藥費增加明顯。 結(jié)論：鞍鋼現(xiàn)存塵肺病例以矽肺為主，，70歲以上老人居多，男性多于女性。以50年代開始接塵，接塵工齡為21~30年的病例居多。塵肺病例大多分布在采選礦、耐火材料等6個行業(yè)。塵肺病以壹期為主要表現(xiàn)，壹期晉貳期的晉期年限最短，塵肺晉期年限隨發(fā)病年齡的上升而縮短。隨著診斷年代的推移，塵肺發(fā)病年齡明顯增大、接塵工齡顯著延長。塵肺病的咳嗽、咳痰、等癥狀隨塵肺期別的提高更加明顯，隨著塵肺期別的進展，肺功能指標逐漸下降的趨勢。塵肺病并發(fā)癥常見，吸煙對塵肺病情有影響。塵肺病住院費用逐年上漲，企業(yè)及社會醫(yī)療保險部門負擔沉重。
[Abstract]:Objective: to understand the epidemiological and clinical characteristics of patients with pneumoconiosis in Anshan Iron and Steel Co. Provide data support for injury insurance. Methods: based on the discharged cases, the pneumoconiosis patients who were admitted to Angang Occupational Disease Hospital from January 2007 to December 2011 were retrospectively investigated. The information of pneumoconiosis stage, factory and mine, type of work, history of dust exposure, years of diagnosis, years of promotion of pneumoconiosis, clinical symptoms and signs were analyzed by 蠂 2 test, rank sum test, variance analysis and Q test. Results: in this study, the average age of the cases was 73.6 years, which was the highest in the age group more than 70 years old. Silicosis accounted for 98.77% of all cases, mainly in stage one of pneumoconiosis. The number of smokers accounted for 25.92% of all cases, and the proportion of smokers in the third stage of pneumoconiosis was the highest. The number of smokers had statistical significance among the different stages of pneumoconiosis. In 1950s, the majority of the patients were exposed to dust (73.16%), and the majority of the patients were exposed to dust for 21 ~ 30 years. The cases of pneumoconiosis are mainly distributed in the mining and mineral processing industry. There was no significant difference in the length of work and age of pneumoconiosis in different workers (P > 0.05). There were significant differences in the mean working age and age of pneumoconiosis between different diagnostic years. The proportion of symptoms such as expectoration, shortness of breath and palpitation increased with the increase of pneumoconiosis, and the difference was statistically significant (P < 0.05). The proportion of tuberculosis, emphysema and cor pulmonale in each stage was compared. The difference was statistically significant (P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, respectively). Conclusion: the majority of the existing pneumoconiosis cases in Anshan Iron and Steel Company are silicosis over 70 years old, male is more than female. Since 50s, dust exposure has been more common, and the dust exposure period is 21 ~ 30 years. The pneumoconiosis cases are mostly distributed in mining and mining. Six industries, such as refractories. Pneumoconiosis is mainly manifested in one stage, the Jin period of the first Jin period is the shortest, and the Jin period of pneumoconiosis is shortened with the increase of onset age. With the passage of diagnostic age, the age of pneumoconiosis onset increases significantly. The symptoms of pneumoconiosis such as cough, expectoration, and other symptoms were more obvious with the increase of pneumoconiosis stage, and with the progression of pneumoconiosis stage, the pulmonary function index decreased gradually. The complications of pneumoconiosis were common. Smoking has an effect on pneumoconiosis. The hospitalization cost of pneumoconiosis is increasing year by year, and the burden of enterprise and social medical insurance department is heavy.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R135.2

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