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目的探讨煤工尘肺合并肺不张的病因和诊断方法。方法选取收治的47例经胸部X射线胸片及胸部CT扫描诊断为肺不张的煤工尘肺患者,通过纤维支气管镜及活体组织检查等手段,进一步明确病因。结果煤工尘肺肺不张的主要病因依次为肺癌(46.8%)、肺结核(17.0%)、肺门淋巴结肿大(12.8%)。纤维支气管镜检查对于支气管腔内生长的肿瘤或炎症有重要诊断价值;而对源于腔外者(外围型肿瘤),穿刺活检和CT扫描更有意义。结论肺癌是导致煤工尘肺肺不张的常见原因,诊断应注意多种方法联合应用。
Objective To explore the etiology and diagnosis of coal workers pneumoconiosis with atelectasis. Methods Forty-seven patients with pneumoconiosis diagnosed as atelectasis by chest X-ray and chest CT scan were selected. The pathogeny was further confirmed by bronchoscopy and biopsy. Results The main causes of pneumoconiosis in coal workers were lung cancer (46.8%), tuberculosis (17.0%) and hilar lymph node enlargement (12.8%). Fiberoptic bronchoscopy is an important diagnostic value for the growth of tumors or inflammation in bronchoalveolar while it is more meaningful for extracapsular (peripheral tumors), biopsy and CT scans. Conclusions Lung cancer is a common cause of pneumoconiosis in coal workers. Diagnosis should be combined with a variety of methods.