中国2018—2021年尘肺病患者全肺灌洗利用情况及其影响因素  

Utilization and influencing factors of whole lung lavage for patients with pneumoconiosis in Chinese mainland from 2018 to 2021

作　　者：陈赟 吕向裴[1] 陈刚 余晨[1] 王焕强[1] 李涛[1] CHEN Yun;Lü Xiangpei;CHEN Gang;YU Chen;WANG Huanqiang;LI Tao(National Institute of Occupational Health and Poison Control,Chinese Center for Disease Control and Prevention,Beijing 100050,China;不详)

机构地区：[1]中国疾病预防控制中心职业卫生与中毒控制所,北京100050 [2]应急管理部北戴河康复院,河北秦皇岛066104

出　　处：《中国职业医学》2023年第1期7-16,共10页China Occupational Medicine

基　　金：中国疾病预防控制中心职业卫生与中毒控制所重点行业职业人群调查(102393220020090000017)。

摘　　要：目的了解尘肺病患者全肺灌洗(WLL)利用情况及其影响因素。方法采用分层随机抽样和非随机抽样相结合的方法,选择2018—2021年中国27个省级行政区(不含上海市、天津市、海南省、西藏自治区)尘肺病患者就医行为调查中的10524例尘肺病患者为研究对象,分析其人口社会学特征、疾病相关因素和经济与社会保障情况对于WLL利用情况的影响。结果尘肺病患者WLL率为17.8%(1871/10524)。促使尘肺病患者利用WLL的主要原因以“医生建议”为主,占65.4%;其次为“周围有尘肺病患者进行WLL”和“病友推荐”,分别占24.1%和18.1%。多因素logistic回归分析结果显示,患者年龄、体质量指数、吸烟指数、文化程度、调查地区、患者来源、目前就业状态、粉尘作业单位性质、尘肺病期别、尘肺病病种、尘肺病相关症状(咳痰、胸痛、呼吸困难、关节疼痛)、WLL禁忌证(肺结核、肺源性心脏病)、家庭年收入、城镇职工医保、医保报销比例、伤残补助、社会资助等均是尘肺病患者利用WLL的影响因素(P值均<0.05)。结论尘肺病患者对WLL的利用比例较大;WLL利用的影响因素包括人口社会学特征、疾病相关因素、经济与社会保障情况等。应最大程度地以保证尘肺病患者的利益为主导,加强对尘肺病患者的职业健康教育与健康促进,规范医疗机构使用WLL行为,以合理利用WLL。Objective To evaluate the utilization and influencing factors of whole lung lavage(WLL)for patients with pneumoconiosis.Methods A total of 10524 pneumoconiosis patients who sought medical treatment from 2018 to 2021 were selected as the research subjects using a combination of stratified random sampling and non-random sampling methods.The patients were from 27 provincial administrative regions of Chinese mainland(excluding Shanghai City,Tianjin City,Hainan Province and Tibet Autonomous Region).The effects of demographic and sociological characteristics,disease-related factors,and economic and social security status on WLL utilization were analyzed.Results The WLL rate of pneumoconiosis patients was 17.8%(1871/10524).The main reason for promoting WLL in pneumoconiosis patients was“doctor′s advice”,accounting for 65.4%;followed by“known-pneumoconiosis-patients had WLL”and“patient′s recommendation”,accounting for 24.1%and 18.1%,respectively.Multivariate logistic regression analysis showed that age,body mass index,smoking index,education level,survey area,source of patients,current employment status,nature of dust-exposed unit,stage of pneumoconiosis,type of pneumoconiosis,pneumoconiosis symptoms(coughing up phlegm,chest pain,dyspnea,joint pain),contraindications to WLL(tuberculosis,pulmonary heart disease),family annual income,medical insurance for urban employees,proportion of medical insurance reimbursement,disability benefits,and social assistance were the influencing factors of WLL utilization in pneumoconiosis patients(all P<0.05).Conclusion A large proportion of pneumoconiosis patients used WLL.The influencing factors of WLL utilization included demographic and sociological characteristics,disease-related factors,economic and social security status,and more.It is necessary to protect the interests of pneumoconiosis patients,strengthen occupational health education and health promotion for pneumoconiosis patients,standardize the use of WLL in medical institutions,and make rational use of WLL.

关 键 词：尘肺病 全肺灌洗 人口社会学 经济 社会保障 影响因素 

分 类 号：R135.2[医药卫生—劳动卫生]