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尘肺

最后审阅: 4 Oct 2024
最后更新: 26 Jan 2023

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
完整详情

其他诊断因素

  • 劳力性呼吸困难
  • 咳嗽
  • 胸部检查正常
  • 胸部听诊时有湿啰音
  • 胸闷和/或哮鸣
  • 胸部听诊时发现有呼气延长和哮鸣
  • 胸部叩诊时有浊音区
  • 紫绀
  • 桶状胸
  • 咯血、发热或盗汗
  • 杵状指和趾
  • 体重减轻
  • 类风湿关节炎或硬皮病的体征
  • 肾功能衰竭的体征(例如:体重升高、水肿、高血压)
完整详情

危险因素

  • 二氧化硅的职业暴露
  • 煤的职业暴露
  • 铍的职业暴露
  • 吸入性二氧化硅或煤的高累积剂量
  • 吸烟
  • HLA-DP1 β 链第 69 号位置的谷氨酸(慢性铍肺)
  • 吸入铍的高累积剂量
完整详情

诊断性检查

首要检查

  • 胸部 X 线检查(后前位和侧位)
  • 肺量测定法
  • 铍淋巴细胞增殖试验 (BeLPT)
完整详情

需考虑的检查

  • 支气管镜活组织检查和/或灌洗
  • 高分辨率胸部 CT 扫描(HRCT)
  • 血氧饱和度
  • 动脉血气 (arterial blood gas, ABG)分析
  • 肺活组织检查
  • 结核病(TB)检测
完整详情

治疗流程

急症处理

急性继发性肺泡蛋白沉积症(急性硅肺病)

急性铍中毒

持续性治疗

慢性硅肺病、煤工尘肺或慢性铍中毒

撰稿人

作者

Kenneth D. Rosenman, MD

Professor of Medicine

Division of Occupational and Environmental Medicine

Michigan State University

East Lansing

MI

利益声明

KDR has given expert testimony in the past. He has active grants from Materion to research natural history of beryllium disease and from the National Institute for Occupational Safety and Health to conduct public health surveillance of occupational lung disease. KDR is an author of several references cited in this topic.

同行评议者

Ware G. Kuschner, MD

Associate Professor of Medicine

Stanford University

Staff Physician

US Department of Veterans Affairs

Palo Alto Health Care System

Palo Alto

CA

利益声明

WGK declares that he has no competing interests.

Harman Paintal, MBBS

Division of Pulmonary and Critical Care Medicine

Veterans Affairs Palo Alto Health Care System (VAPAHCS)

Palo Alto

CA

利益声明

HP declares that he has no competing interests.

Francis Thien, MD, FRACP, FCCP

Professor

Box Hill Hospital and Monash University

Victoria

Australia

利益声明

FT declares that he has no competing interests.

Edward L. Petsonk, MD

Professor of Medicine

Section of Pulmonary and Critical Care Medicine

West Virginia University School of Medicine

Morgantown

WV

利益声明

ELP declares that he has no competing interests.

Christopher M. Barber, BM, BS, BMedSci, FRCP, MD, AFOM

Respiratory Consultant

Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield

UK

利益声明

CMB declares that he has no competing interests.

Carl J. Reynolds, MBBS, MRCP, BSc, MSc, PhD, DPMSA

Respiratory Consultant

Honorary Senior Clinical Lecturer

North Middlesex University Hospital

Imperial College London

UK

利益声明

CJR declares that he has no competing interests.

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