本文選題：塵肺 + 影響因素��； 參考：《泰山醫(yī)學(xué)院》2012年碩士論文

【摘要】：目的 分析泰安市塵肺病患病現(xiàn)狀、變動趨勢及發(fā)病危險因素，分析泰安市塵肺病防治、治療存在的問題，為預(yù)防塵肺病提供科學(xué)依據(jù)，針對泰安市塵肺病患病現(xiàn)狀，提出技術(shù)途徑與措施。 方法 收集泰安市職業(yè)病醫(yī)院2002-2006年確診的具有診斷證明書的塵肺患者病例資料，按期別、工種、病種、年齡、粉塵接觸年限、合并癥、肺功能損傷程度、企業(yè)性質(zhì)、季節(jié)、月份等進行統(tǒng)計，用Excel2003建立數(shù)據(jù)庫。塵肺患者的診斷，根據(jù)《塵肺病診斷標準》（GBZ70－－2002）進行，由泰安市職業(yè)病醫(yī)院職業(yè)病診斷小組3名以上取得職業(yè)病診斷資格的執(zhí)業(yè)醫(yī)師集體診斷，診斷過程如實記錄并備案。診斷結(jié)論根據(jù)半數(shù)以上診斷醫(yī)師的一致意見形成，參與診斷的醫(yī)師最后共同簽名。 用SPSS15.0統(tǒng)計軟件進行統(tǒng)計分析，包括χ2檢驗和logistic回歸分析。 結(jié)果 1.發(fā)病概況：2002年--2006年泰安市確診的具有診斷證明書的塵肺病病例資料645例，平均每年發(fā)病129例。均為男性。塵肺在冬季構(gòu)成比最高，占全部病例的48.8%，其次是春季，占24.7%，秋季占15.0%，夏季占11.5%。 2.年齡別發(fā)病構(gòu)成：20--歲年齡組占6.0%，41--歲年齡組占55.2%，在61歲以上組占38.8%。說明壯年組發(fā)病最高。 3.工種構(gòu)成：掘進工種的塵肺病構(gòu)成比最高，占44.8%，其次是采煤工（24.3%）、輔助工（13.0%）、回采工（7.3%）、運搬工（2.8%）、鑄造工（2.5%）、電焊工（2.2%）、巷修工（1.9%）、水泥工（1.1%）、井下機電工（0.2%）。可見掘進工和采煤工兩個工種是塵肺病發(fā)病高危工種。 4.接塵時間、單位性質(zhì)、病種與發(fā)病：接觸粉塵年限在21年--30年的塵肺構(gòu)成比最高，占50.1%,其次是11年--20年，占29.5%,31年--40年，占11.5%，小于等于10年，占9.0%；國有企業(yè)的塵肺構(gòu)成比最高，占87.4%，私有企業(yè)占12.6%；煤工塵肺的構(gòu)成比最高，占93.0%，其次是矽肺（2.3%），鑄工塵肺（2.2%），，水泥工塵肺（1.4%），電焊工塵肺（1.1%）。 5.肺功能損傷及合并癥分析：無肺功能損傷的占全部病例的64.2%，肺功能輕度損傷的占7.4%，肺功能中度損傷的占28.4%；Ⅰ期塵肺占全部病例的89.0%，Ⅱ期塵肺占9.8%，Ⅲ期塵肺占1.2%；塵肺合并呼吸系統(tǒng)感染的構(gòu)成比最高，占94.6%，其次是合并肺結(jié)核，占3.0%，合并肺心病，占1.6%，合并氣胸，占0.8%。 肺功能損傷分級與年齡有相關(guān)性，χ2=83.185，P0.01；肺功能損傷分級與接觸粉塵年限有相關(guān)性，χ2=39.062，P0.01；肺功能損傷分級與塵肺期別有相關(guān)性，χ2=41.104，P0.01。多因素分析證實接觸粉塵年限、年齡等對肺功能損傷分級有影響。 結(jié)論 1.塵肺病的發(fā)病以壯年組最高，多數(shù)在冬季發(fā)病，提示我們冬季預(yù)防呼吸道感染為塵肺病防治的一個重要環(huán)節(jié)。 2.掘進工和采煤工是塵肺病發(fā)病最高危的兩個工種，說明這兩個工種的工作環(huán)境條件沒有達到塵肺病防治的要求，即這兩個工種是塵肺病預(yù)防控制的薄弱環(huán)節(jié)。 3.塵肺病易合并呼吸系統(tǒng)感染、肺結(jié)核、肺心病、氣胸等并發(fā)癥。以呼吸系統(tǒng)感染為主。這些并發(fā)癥加重了病情的進展。積極及時地治療并發(fā)癥是延長患者壽命的重要內(nèi)容。 4.國有企業(yè)塵肺病發(fā)病嚴重，與防塵制度的落實不到位，煤礦工人自我保護意識不高有關(guān)。提示我們必須加強督導(dǎo)和監(jiān)督檢查，貫徹落實預(yù)防為主的思想，才能有效地預(yù)防塵肺病的發(fā)生。 5.肺功能損傷分級與年齡、接觸粉塵年限、塵肺期別有相關(guān)性。 6.建議應(yīng)為塵肺病人注射卡介苗，在冬春季節(jié)注射流感疫苗，以增強機體的免疫力，防止合并癥的發(fā)生。 7.有關(guān)部門應(yīng)該加強防塵管理和組織領(lǐng)導(dǎo)，建立健全相應(yīng)的規(guī)章制度，做好衛(wèi)生監(jiān)督，定期監(jiān)測粉塵濃度。同時要大力加強職業(yè)病防護知識的宣傳教育，提高煤礦工人的自我保護意識。
[Abstract]:Purpose

This paper analyzes the current situation , trend and risk factors of dust - lung disease in Taian City , analyzes the problems existing in the prevention and treatment of dust - lung diseases in Taian City , and provides scientific basis for the prevention of dust and lung diseases , and puts forward the technical means and measures for the current situation of the dust - lung disease in Taian City .

method

The diagnosis of patients with dust - lung disease was established according to the diagnostic criteria of occupational diseases ( GBZ70 - -2002 ) in Taian occupational disease hospital , and the diagnosis was recorded and recorded according to the diagnosis standard of occupational diseases ( GBZ70 - -2002 ) . The diagnosis conclusion was formed according to the agreement of more than half of the diagnosis physicians , and the doctor who participated in the diagnosis finally signed together .

Statistical analysis was performed with SPSS 15.0 statistical software , including 蠂2 test and logistic regression analysis .

Results

1 . Overview of morbidity : In 2002 - 2006 , there were 645 cases of dust - related pulmonary disease diagnosed in Taian City in 2002 . The average rate was 129 cases per year . All cases were male . The dust - lung was the highest in winter , accounting for 48.8 % of all cases , followed by spring , accounting for 24 . 7 % , autumn in 15.0 % , and in summer 11.5 % .

2 . Age : 6.0 % of the 20 - year - old age group , 55.2 % of the 41 - year - old age group , and 38.8 % in the 61 - year - old group .

3 . There are two types of work species : the proportion of dust and lung disease of the tunneling work is the highest , accounting for 44.8 % , the second is the coal mining industry ( 24.03 % ) , the auxiliary worker ( 13.0 % ) , the welders ( 7.2 % ) , the roadway maintenance ( 1.9 % ) , the cement worker ( 1.1 % ) , the underground electro - mechanic ( 0.2 % ) .

4 . Dust exposure time , unit property , disease and morbidity : The dust - free years of exposure to dust ranged from 21 years to 30 years , accounting for 50.1 % , followed by 11 years - 20 years , accounting for 29 . 5 % , 31 - 40 years , 11.5 % , less than or equal to 10 years , accounting for 9.0 % ;
In the state - owned enterprises , the ratio of dust - to - lung was the highest , accounting for 87.4 % , and private enterprises accounted for 12.6 % ;
The composition ratio of the coal worker ' s dust - lung was 93.0 % , followed by the silicotic lung ( 2.3 % ) , the foundry dust - dust ( 2.2 % ) , the cement dust - dust ( 1.4 % ) , the electric welder ' s dust - lung ( 1.1 % ) .

5 . Analysis of lung function injury and complications : 64.2 % of all cases with no lung function injury , 7.4 % in lung function and 28 . 4 % of moderate lung injury ;
There were 89.0 % of all cases in stage 鈪

本文編號：2107351