进行性石工尘肺合并纤维性间质性肺炎：病例报告。
Progressive plasterer's pneumoconiosis complicated by fibrotic interstitial pneumonia: a case report.
机构信息
Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Department of Pulmonary Medicine, National Hospital Organization Utsunomiya National Hospital, 2160 Shimo-Okamoto, Utsunomiya, Tochigi, 329-1193, Japan.
出版信息
BMC Pulm Med. 2019 Jan 7;19(1):6. doi: 10.1186/s12890-018-0776-4.
BACKGROUND
Although the prevalence of pneumoconiosis has been decreasing due to improvements in working conditions and regular health examinations, occupational hygiene measures are still being established. Plasterers encounter a number of hazardous materials that may be inhaled in the absence of sufficient protection.
CASE PRESENTATION
A 64-year-old man who plastered without any dust protection for more than 40 years was referred to our hospital with suspected interstitial pneumonia. Mixed dust pneumoconiosis and an unusual interstitial pneumonia (UIP) pattern with fibroblastic foci were diagnosed by video-assisted thoracoscopic surgery, and an elemental analysis detected elements included in plaster work materials. Despite the cessation of plaster work and administration of nintedanib, the patient developed advanced respiratory failure.
CONCLUSION
Plasterers are at an increased risk of pneumoconiosis and may have a poor prognosis when complicated by the UIP pattern. Thorough dust protection and careful monitoring are needed.
背景
尽管由于工作条件的改善和定期健康检查，尘肺病的患病率有所下降，但职业卫生措施仍在建立中。瓦工在没有充分保护的情况下会接触到许多可能被吸入的有害物质。
病例介绍
一名 64 岁男性，从事瓦工工作超过 40 年，未采取任何防尘措施，因疑似间质性肺炎就诊于我院。胸腔镜手术诊断为混合性尘肺病和不常见的间质性肺炎（UIP）模式，伴有成纤维细胞灶，并通过元素分析检测到包含在灰泥工作材料中的元素。尽管停止了灰泥工作并使用尼达尼布治疗，但患者仍出现了严重的呼吸衰竭。
结论
瓦工患尘肺病的风险增加，当合并 UIP 模式时，预后可能较差。需要彻底的防尘保护和仔细的监测。
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