矽肺合并空洞性肺结核63例临床特征及随访分析  

Clinical characteristics and follow-up analysis of 63 cases of silicosis complicated with cavity-pulmonary tuberculosis

作　　者：董志鹏 崔乔义 潘少平 赵玉香 Dong Zhipeng;Cui Qiaoyi;Pan Shaoping;Zhao Yuxiang(Department of Occupational Disease,Yantaishan Hospital,Yantai 264000,China;Department of Clinical Laboratory,Yantai hospital of Traditional Chinese Medicine,Yantai 264013,China)

机构地区：[1]烟台市烟台山医院职业病科,烟台264000 [2]烟台市中医医院检验科,烟台264013

出　　处：《中华劳动卫生职业病杂志》2024年第4期268-270,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的探讨矽肺合并空洞性肺结核的临床特征及转归。方法收集2018年7月至2022年7月烟台市烟台山医院收治的63例矽肺合并空洞性肺结核患者(A组)及同期住院的矽肺患者(B组)的临床资料并进行统计分析。结果A组63例患者均为男性,咳嗽、咳痰、胸闷、气短、咯血为常见症状。CT示空洞性病变常累及多肺叶,多发生在肺上叶尖后段、下叶背段及后基底段,厚壁空洞多见,可伴有卫星病灶、支气管播散灶、气胸、胸腔积液等。B组患者1225例,咯血59例(4.8%),空洞3例(0.2%),咯血和/或空洞发生率明显低于A组,差异有统计学意义(P<0.05)。A组患者抗结核治疗后6~24月复查CT,52例(82.5%)空洞缩小/愈合,8例(12.7%)复发,3例(4.8%)形成毁损肺(死亡2例)。结论矽肺患者出现咯血和/或CT出现空洞时需高度警惕合并肺结核,抗结核治疗和/或动态CT随访有助于实验室检查阴性患者明确诊断。ObjectiveTo investigate the clinical characteristics and prognosis of silicosis complicated with cavity-pulmonary tuberculosis.MethodsThe clinical data of 63 patients with silicosis complicated with cavity-pulmonary tuberculosis(group A)and silicosis patients(group B)admitted to Yantaishan Hospital from July 2018 to July 2022 were collected and analyzed.ResultsPatients in group A were all male,and the common symptoms were cough,expectoration,chest tightness,shortness of breath,and hemoptysis.CT cavity lesions involving the lung,often occurs in the lung after the tip section,after the back section and basal segment,thick-walled cavity,may be accompanied by satellite lesions,endobronchial spread focal,pneumothorax,pleural effusion,etc.1225 cases of group B patients haemoptysis of 59 patients,cavity in 3 patients,haemoptysis and/or cavity rate was lower than that in group A,the difference was statistically significant(P<0.05).In group A,CT reexamination 6-24 months after anti-tuberculosis treatment showed that 52 cases(82.5%)had cavity reduction/healing,8 cases(12.7%)had recurrence,and 3 cases(4.8%)had damaged lung(2 died).ConclusionSilicosis patients with hemoptysis and/or CT in cavity should be more vigilant about combined tuberculosis,anti-tuberculosis treatment and/or dynamic CT follow-up helps laboratory diagnosis negative patients.

关 键 词：矽肺 肺结核 肺空洞 临床特征 随访 

分 类 号：R135.2[医药卫生—劳动卫生] R521[医药卫生—公共卫生与预防医学]