A history of human civilization is actually a history of mineral resources utilization. Mining production has provided great material wealth for the society, but at the same time, due to the poor working conditions in the production workplace, the air in the working environment is seriously polluted by toxic and harmful substances, and various occupations are generally high, which poses a serious threat to the safety and health of workers.
People live in a dusty environment every day. The human body blocks the dust through nose hair and spits out the dust sucked into the mouth by spitting out prizes. This kind of self-defense function of human beings can expel large particles of dust from the body, and only a very small amount of particle dust enters the human body, which will not cause harm to the human body, especially the lungs. Li Ming (pseudonym), who has been working underground for many years, is not so lucky.
Li Ming, 37, a farmer from Sichuan to Shanxi, started coughing, expectoration, chest tightness and shortness of breath/kloc-0 years ago, and went to the hospital because of the sudden aggravation of the above symptoms. The examination results show that Li Ming suffers from silicosis. So can silicosis be prevented? Can silicosis be cured? The reporter interviewed Sheng, vice president of Shanxi Occupational Disease Hospital.
Etiology and symptoms of silicosis, also known as silicosis, is the most common type of pneumoconiosis, mainly manifested in extensive nodular fibrosis of the lungs. The cause of silicosis is long-term inhalation of a large number of free silica dust, which is the most common, fastest-growing and most harmful type of pneumoconiosis. According to relevant data, there are currently 600,000 pneumoconiosis patients in China, which is equivalent to the sum of pneumoconiosis patients in other countries and regions in the world.
According to the statistical data reported by cities in Shanxi Province, by the end of 2007, 36,202 cases of lung disease had been found and 8,665,438+00 cases had died. However, the incidence of coal miners accounts for the vast majority. So why are coal miners prone to silicosis? Dean Yin introduced that in the process of coal mining, because the content of free silica in coal mine strata can sometimes be as high as more than 40%, miners' operations are frequently mobilized, and the dust that miners are exposed to is mostly coal-silicon mixed dust.
Coal silicosis is the most common type of pneumoconiosis among coal miners, which is mainly caused by inhaling a large amount of coal silica dust for a long time in production. The length of service of onset is about 15~20 years, and the lesion develops rapidly and is harmful. In addition to coal miners, workers exposed to rocks, such as coal miners and iron miners, are also prone to silicosis.
After the onset of silicosis, the lesion can continue to develop even if it is separated from dust work. A few people get sick after 1~2 years due to continuous inhalation of dust with high concentration and high free silica content, which is called hairline pneumoconiosis.
After several years of exposure to dust, it was diagnosed as silicosis, which is called "late-onset silicosis". There are three symptoms of silicosis: chronic silicosis, acute silicosis and accelerated silicosis in between. Morphology is significantly related to dust concentration, silicosis content and dust exposure years, and chronic silicosis is the most common in clinic. Generally, there may be no symptoms or obvious symptoms in the early stage, and various symptoms may appear with the progress of the disease. Symptoms are not specific, and the severity of symptoms is often inconsistent with silicosis.
Gas rise often occurs earlier and is gradually aggravated. I often feel chest tightness and slight chest pain in the early stage, which is swelling pain, dull pain or tingling, and has nothing to do with breathing, * * and labor process. The degree of chest tightness and shortness of breath is related to the scope and nature of the lesion. In the early stage, due to inhalation of silica dust, cough may occur, and those who are infected or smokers may have expectoration.
A few patients have blood in their sputum, complicated with tuberculosis and lung cancer, and may also have repeated or severe hemoptysis. Patients can still have dizziness, fatigue, insomnia, palpitations, loss of appetite and other symptoms.
Early silicosis can have no abnormal signs, and corresponding signs will be produced with the progress of the disease and the occurrence of complications. The third stage silicosis is caused by the contraction of lung tissue by large fibers, which leads to bronchial displacement and voiced sound. If complicated with chronic bronchitis, emphysema and pulmonary heart disease, there may be corresponding signs.
The diagnosis and treatment of silicosis are based on the patient's close contact history with silica dust and detailed occupational history, combined with the corresponding necessary examinations to rule out other possibilities, and then based on the comprehensive analysis of X-ray chest films, the diagnosis stages are made. Once silicosis is diagnosed, it should be separated from dust work and given active comprehensive treatment. Life expectancy can be extended to the average life expectancy of ordinary people, but their labor force may be lost.
The death of silicosis is often caused by severe tuberculosis, spontaneous pneumothorax and respiratory failure. For silicosis complicated with pulmonary tuberculosis, due to the slow response, standard chemotherapy scheme should be adopted instead of short-term chemotherapy for pulmonary tuberculosis. Comprehensive measures should be taken for silicosis patients, including dust removal, other appropriate work, strengthening nutrition and appropriate rehabilitation treatment on the basis of drug treatment, and living regularly to delay the progress of the disease and prevent complications.
At present, it is recognized that the most effective treatment is whole lung lavage: mechanical lavage removes phospholipids from alveoli and improves the ventilation function of alveoli, thus relieving symptoms such as cough and dyspnea and correcting severe hypoxia.
However, there have been different views on this therapy in academic circles, and some experts believe that this etiological therapy has important clinical value. However, some experts believe that this technology is mainly suitable for suspected pneumoconiosis and primary pneumoconiosis, and it cannot fundamentally reverse the final pathological changes of lung tissue fibers of pneumoconiosis.
In terms of drug therapy, there is no drug that can completely reverse silicosis at present, and drug therapy is mainly to organize or inhibit the progress of silicosis at an early stage. Complications of silicosis and pulmonary tuberculosis: It is a common and serious complication of silicosis, up to 20%~50%. Autopsy found more than before, about 36%~80%. And it will increase with the progress of silicosis. The incidence of pulmonary tuberculosis in stage ⅰ ~ ⅱ is ~ 100%, and that in stage ⅲ is over 50 ~ 90%.
Tuberculosis accounts for 45% of the direct death cause of silicosis. Silicosis complicated with pulmonary tuberculosis will promote each other and accelerate the deterioration. Poisoning symptoms such as fever often appear, and hemoptysis is one of the symptoms. Tuberculosis can be found in sputum. Tuberculosis cavity is often large, irregular in shape, mostly eccentric, with * * * protrusions on the inner wall, which look like caves, and the pleura around tuberculosis focus is thickened.
Pulmonary infection: it is the most common complication of silicosis, which can promote the development of silicosis and induce respiratory failure and death. Therefore, we should actively prevent and treat respiratory tract infections, especially for advanced silicosis.
And obstructive emphysema: long-term inhalation of dust damages bronchial ciliary epithelium. Diffuse nodular fibrosis of lung leads to bronchial stenosis, poor drainage, easy infection, chronic bronchitis and cor pulmonale. Severe infection can induce respiratory failure and right heart failure.
Spontaneous pneumothorax: more common in patients with emphysema and bullae, especially in patients with advanced silicosis. Pulmonary infection, severe cough and fatigue are common causes. Common symptoms. The recurrence rate of silicosis complicated with pneumothorax is high, localized pneumothorax is common, and the signs are atypical. Because of fibrosis of lung tissue and pleura.
Fracture is difficult to heal and gas absorption is slow. How to effectively prevent silicosis patients from having close contact history with silica dust and occupational history, and there are many types of jobs that cause silicosis. Workers who have been exposed to various metals, coal powder, refractories, stone powder, cement, glass and ceramics for a long time may suffer from silicosis.
1. Dust prevention is the key to control or reduce the incidence of silicosis. Industrial and mining enterprises should take comprehensive dust prevention measures such as production process reform, wet operation, sealing dust source, ventilation and dust removal, and equipment maintenance and repair.
2. Strengthen personal protection and pay attention to dust prevention. Regularly monitor the dust concentration in the air of production environment and strengthen publicity and education. Have a physical examination before employment, including X-ray chest film.
3. Patients with active pulmonary tuberculosis and various respiratory diseases should not participate in silica dust operations. Strengthen the regular physical examination of workers exposed to silica dust, including X-ray chest film. The interval of examination depends on the content of exposed silica dust and the concentration of air dust.
4. Strengthen the prevention and treatment of tuberculosis in industrial and mining areas. Those with negative tuberculin test should be vaccinated with BCG; Preventive anti-tuberculosis chemotherapy was given to positive patients to reduce the incidence of silicosis complicated with pulmonary tuberculosis.
5. Comprehensive measures should be taken for silicosis patients, including dust removal, separate arrangement of appropriate work, strengthening nutrition and proper health care. Prevent respiratory tract infections and complications.
Silicosis prescription 1. Water chestnut and radish juice, fresh water chestnut and fresh white radish100g each, and appropriate amount of rock sugar. Wash water chestnut and radish, pound juice, add rock sugar and stew with water. Take it twice a day to treat cough, dry throat, poor expectoration or blood in sputum.
2. 60 grams of kelp and 30 grams of jellyfish, soaked in brown sugar, chopped, boiled, washed and shredded. Mix the two, add brown sugar and eat it two or three times a day or with meals, which can eliminate phlegm, remove thick phlegm, remove lung nodules, diminish inflammation and moisten dryness.
3. Lily and mung bean soup Lily 150 ~ 250g, mung bean 50 ~ 100g, and appropriate amount of rock sugar. Boil lily and mung bean thoroughly in water and mix well. Indications are thick phlegm, afternoon hot flashes or silicosis, three times a day.
4. Bean sprouts, pig blood, 250 grams of soybean sprouts, 250 grams of pig blood, boiled in soup. Regular consumption has a certain effect on the dryness of stool and the removal of "toxins" in silicosis patients.
5. Porphyra soup Porphyra soup (dry) 15 g, dried laver 9 g, cucumber 10 g, and appropriate seasoning. Wash laver and cucumber, cut into pieces, first boil the water in the pot, then add cucumber slices, dry rice, salt and soy sauce to remove the foam on the water, then add laver, drizzle with sesame oil and monosodium glutamate, and eat while it is hot. Daily 1-2 times, can clear away heat and toxic materials and eliminate pulmonary silicosis.
6. Jewelry porridge, 60 grams of raw rice medicine and raw glutinous rice, and 3 grams of persimmon cream. Wash yam and coix seed and mash them into coarse powder, put them into a pot, add appropriate amount of water, and cook them until they are cooked thoroughly. Before taking them, mix persimmon cream evenly, which is more effective for people with qi deficiency, anorexia and cough with sparse phlegm.
7. Drink 50 grams of honey and take it with warm water. Once in the morning and once in the evening, it is effective for silicosis patients with sore throat, dry cough or chest pain, and can be eaten frequently. There are several taboos for silicosis patients: Chili: spicy food. Silicosis patients have insufficient lung qi, so they should not eat Chili.
Betel nut: warm in nature, bitter and pungent in taste, can kill insects, break accumulation and hurt people. People suffering from silicosis for a long time are weak and lose their vitality. They can't eat too much for a long time. Cigarettes: silicosis patients should definitely ban smoking. Salt: cold in nature and salty in taste. People with chronic silicosis should have a light diet, not too salty. Apricot: It's warm.
According to the experience of ancient doctors, eating more food is easy to help heat produce phlegm, which is not conducive to silicosis patients. Pomegranate: Although there are sweet pomegranate and sour pomegranate, both of them can damage lung qi. People with silicosis have lung qi deficiency, and phlegm and dust hinder the lungs. It is not advisable to eat more pomegranate.
Amomum villosum: warm in nature and pungent in taste, it is a commonly used dual-purpose condiment for medicine and food. Although it has the function of appetizing, it is spicy and has the disadvantages of consuming gas and hurting yin and helping heat to get angry. People with lung qi deficiency and lung heat should not eat it. In addition, silicosis patients should also avoid liquor, garlic, cherries and spicy foods such as pepper, pepper, fennel and cinnamon.
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