四种金属盐对职业性接触者皮肤致敏性的观察

<正> 电镀工业中因接触铬、镍等金属盐引起皮肤、鼻、咽部损害如铬疮、鼻中隔穿孔等在国内早有报告。(1～2)但有关这类化合物引起皮肤接触性敏感反应问题,在国内尚少有报导。为此,我们于一九八○年冬对两家电镀厂直接及间接接触四种常用金属盐类(重铬酸钾、硫酸镍、硫酸铜及硫酸锌)的261名职工的皮肤情况作了调查,并于一九八五年夏对其中的104名作了随访。藉皮肤班贴试验着重探讨4种金属盐诱发皮肤接触性敏感的一些特点。     

蚌埠市大中专学生鼻中隔偏曲状况的调查

目的：了解大中专学生鼻中隔编曲的患病情况，探讨鼻中隔编曲与症状的关系。方法：采用前鼻镜及鼻内窥镜对本市9232名大中专学生进行调查。结果：鼻中隔偏曲的患病率为3．4％，前部及C到偏曲易引起鼻塞和上呼吸道感染，且出血等症状较重。高位偏曲易产生头昏、头痛。结论：鼻中隔亿曲的部位与症状关系密切，患病率明显低于文献报道。     

鼻内窥镜下鼻底粘膜瓣修补鼻中隔穿孔

目的探讨鼻内窥镜下鼻底粘膜瓣修补鼻中隔穿孔的方法及疗效。方法对10例鼻中隔穿孔患者行鼻内窥镜下单侧带蒂鼻底黏膜瓣修补鼻中隔穿孔。结果 10例患者鼻中隔穿孔均修补成功,并一期愈合,未出现手术并发症,随访6个月-1.5年,鼻中隔未见再次穿孔。结论经鼻内镜鼻底粘膜瓣修补鼻中隔穿孔具有术野清晰,取材方便,容易存活,是修补鼻中隔穿孔有效的方法。     

氟及其无机化合物对作业工人鼻和咽部的损害

氟及其无机化合物对人体鼻和咽部的损害日益为人们所重视。曾有报道,从事氟作业的工人有鼻干燥感,鼻中隔或鼻甲溃疡,咽淋巴滤泡增生等。为探讨氟中毒的诊断标准,我们于1979年对抚顺某铝厂220名氟作业工人进行了健康检查,现将结果报告如下。     

旋转鼻底带蒂黏膜瓣复合阔筋膜修补鼻中隔大穿孔的效果分析

目的 探讨鼻内镜下旋转鼻底带蒂黏膜瓣复合阔筋膜修补鼻中隔穿孔的效果.方法 在鼻内窥镜下准备移植床及鼻底带蒂黏膜瓣,利用大腿阔筋膜作为移植材料,复合瓣法修补鼻中隔穿孔6例.结果 随访0.5～1年,6例鼻中隔穿孔均愈合,未发生再穿孔.结论 鼻内窥镜下旋转鼻底带蒂黏膜瓣复合阔筋膜修补鼻中隔大穿孔有很好的临床价值.     

鼻中隔矫正术治疗变应性鼻炎的疗效分析

目的探讨合并鼻中隔偏曲的变应性鼻炎（ allergic rhinitis, AR）及手术矫正鼻中隔偏曲治疗的效果。方法对113例确诊为AR合并鼻中隔偏曲鼻息肉患者分组,分别行鼻中隔鼻内镜下矫正术和鼻中隔鼻内镜下矫正术＋息肉摘除术,术后3个月、6个月、1年进行随访,观察疗效并进行分析。结果3个月有效率为94．4％,6个月有效率为92．9％,1年有效率为90．3％。结论对合并有鼻中隔偏曲的AR患者行鼻内镜鼻中隔矫正术,疗效较好。     

鼻内镜下鼻中隔软骨整形术

目的：探讨鼻内镜下鼻中隔矫正手术中鼻中隔软骨的整形方法。方法：将101例鼻中隔偏曲患者分实验组与对照组,以不同方式行鼻中隔矫正术,比较两组术后疗效。结果：实验组48例患者术中行鼻中隔软骨整形,术后随访3～6个月无鼻中隔穿孔、血肿及鼻腔粘连,效果优于对照组。结论：在鼻内镜下鼻中隔偏曲矫正手术中将鼻中隔软骨整形可以有效降低术后鼻中隔穿孔等并发症的机率。     

鼻内镜手术治疗青少年鼻中隔偏曲的体会

目的观察鼻内镜下青少年鼻中隔成形术的疗效及并发症。方法应用鼻内镜对36例青少年鼻中隔偏曲患者施行鼻中隔成形术,随访至18岁,观察其疗效及并发症。结果 36例患者获满意通气效果,鼻外观无异常,术后并发鼻中隔血肿1例,鼻腔粘连3例。结论鼻内镜下行鼻中隔成形术损伤小,疗效好,无明显并发症,对有症状的青少年鼻中隔偏曲患者是可以采用的有效方法。     

297名电镀作业工人皮肤、鼻、咽部损害情况的调查

为了解我县乡镇企业电镀业职业性危害情况,我们于1988年对10家厂297名工人统一采用铬作业工人体格检查表,并根据国家GD7798—87职业性铬鼻病诊断标,通过详询职业史,以皮肤、鼻、咽     

鼻内镜下鼻中隔成形术在青少年中的临床应用体会

目的 探讨鼻内镜下鼻中隔成形术在青少年中的临床应用价值.方法 青少年鼻中隔偏曲患者288例,均于鼻内镜下行鼻中隔成形术,其中156例患者术后随访1～5年.结果 术后患者症状均消失或明显减轻,无鼻面部发育障碍发生.结论 对于青少年鼻中隔偏曲行鼻内镜下鼻中隔成形术疗效显著,安全可靠,不会导致鼻面畸形.     

Clinical thinking and decision-making in practice. A patient with arthritis, skin lesions and a perforated nasal septum]

A man aged 38 years had arthritis, skin lesions and a perforation of the nasal septum. He had slight deterioration of renal function and a few granular casts in the urine. Antineutrophil cytoplasmic antibody and other immune parameters were normal. A biopsy of the nasal septum did not show granulomatous lesions. The differential diagnosis on the available clinical grounds could be narrowed to Wegener's disease, Henoch-Sch?nlein vasculitis or microscopic polyangiitis. A biopsy of the skin showed leukocytoclastic vasculitis, with IgA and IgM depositions compatible with Henoch-Sch?nlein vasculitis. A renal biopsy showed small segmental necrotising lesions of the glomerular capillaries, with minimal extracapillary proliferation; immune fluorescence did not detect any significant depositions. The picture was compatible with Wegener's disease. A nasal septum defect together with glomerulonephritis, which could be suspected from only minimal abnormalities in the urine, is almost conclusive for the diagnosis.     

鼻内窥镜下鼻中隔偏曲手术及下鼻甲肥大微波治疗的疗效分析

目的探讨鼻内窥镜下手术治疗鼻中隔偏曲加微波热凝肥大下鼻甲术的效果。方法局部的麻醉加浸润麻醉对69例鼻中隔偏曲患者在鼻内窥镜下行鼻中隔偏曲矫正术,其中68例并发对侧下鼻甲代偿性肥大者同时行下鼻甲微波热凝术,1例因下鼻甲骨性肥大行黏膜下切除术加微波热凝术。结果手术后3个月鼻塞、鼻出血、头痛症状完全消失51％-64％范嗣。术后3-12个月痊愈55例．好转10例,无效4例,总有效率（痊愈加好转）92．7％,未见1例并发症。结论鼻中隔矫正术与肥大下鼻甲微波热凝术治疗鼻中隔偏曲疗效良好。     

低浓度铬酸雾的危害识别

以某电筒厂铬电镀工人86名为对象,通过询问、体格检查、鼻咽部检查、嗅觉测定、皮肤检查、肺功能测定及空气铬酸浓度测定,结果发现在空气几何平均浓度0.011～0.032CrO_3mg/m~3之间,21%的接触者出现鼻粘膜的糜烂,但未见到鼻粘膜溃疡的反应,肺功能测定值接触组与对照组相比,差别无显著性,皮肤检查未发现铬溃疡与接触性皮炎的增多,主观症状主要为口鼻刺激症状、皮肤刺激症状及神经衰弱症状。     

Nasal septum lesions caused by chromium exposure among chromium electroplating workers

A chromium electroplating worker, suffering from epistaxis during work, was found to have nasal septum perforation. To determine the etiology and prevalence of nasal septum lesions, we conducted a survey of seven chromium electroplating factories and examined 79 workers. Forty workers from three aluminum electroplating factories were also enrolled as the reference group. Subjects were thoroughly examined by an otolaryngologist and each of them provided a blood and urine sample. A questionnaire interview regarding symptoms of the upper respiratory tract, past medical history, life style, and work history was also conducted. Air chromium concentrations were measured by taking area samples for 4–6 hours. Based on field observation and chromium measurements, we divided chromium electroplating into three different exposure zones: workers directly dealing with electroplating tanks (n = 31), other process workers (n = 29), and office workers and drivers (n = 19). Among the 79 chromium electroplating workers, there were 16 cases of nasal septum perforation, and 42 with either scar formation or ulceration; 10 chromium electroplating workers developed skin ulcers after performing chrome plating. No workers from aluminum electroplating factories had any nasal septum or skin abnormalities. There was a consistent trend between the degree of chromium exposure and the signs and symptoms related to the nose, throat, and skin. Immediate improvement of occupational hygiene is warranted.     

Cutaneous leishmaniasis in south-eastern Paraguay: a study of an endemic area at Limoy.

An epidemiological study was performed on leishmaniasis in a newly established community in south-eastern Paraguay. 149 persons, of 172 inhabitants, were thoroughly examined by clinical, parasitological and immunological (leishmanin skin test) examinations. 88 of those examined (59%) were clinically positive for dermal and nasal (mucosal) lesions or dermal scars, while 74 (50%) were positive by the leishmanin test. Of the 88 persons, 66 (75%) were positive for both leishmanial (dermal and nasal) signs and skin test; these subjects were therefore considered to be leishmaniasis patients. Most of the patients (60%) had a single dermal lesion. Among the 66 leishmaniasis patients, serious mucosal (nasal septum) lesions were observed in the 41 subjects: 2 had destruction of the septum, 8 had ulceration and 31 had erythema. In this community the persons with dermal and/or nasal problems had been treated with meglumine antimonate (Glucantime), without any precise diagnosis having been made by parasitological or immunological examination. The socio-economical and socio-medical points of view aspects are discussed.     

鼻中隔瓣联合带蒂皮瓣整复下眼睑基底细胞癌切除后缺损的观察

目的探讨应用游离鼻中隔粘软骨膜软骨瓣联合局部带蒂皮瓣整复下眼睑基底细胞癌全切除后下眼睑缺损的方法。方法 5例下眼睑基底细胞癌患者,肿瘤全部占据下眼睑的2/3,在行全层下眼睑肿瘤切除后,应用游离鼻中隔粘软骨膜瓣联合局部带蒂皮瓣修复下眼睑。结果 5例患者均达到保证眼睑功能和美观的效果,无术后感染,无移植皮瓣坏死现象。无睑内翻和睑外翻,随访5～10年无复发病例。结论下眼睑基底细胞癌在侵犯全部下眼睑的2/3时,必须行下眼睑全切除,切缘应在2～3mm以上,确保不残留癌组织,全下眼睑缺损应用游离鼻中隔粘软骨膜软骨瓣联合局部带蒂皮瓣修复是一个很好的修复方法。     

铬接触工人402名职业性健康检查结果分析

目的 了解宝山区铬作业工人的健康状况，为预防铬职业危害提供依据。方法 对402名铬接触工人2002年职业性健康检查资料进行统计分析，项目包括鼻腔疾病及内科常规检查。结果 鼻腔疾病检出率13．4％，其中鼻粘膜糜烂和鼻中隔穿孔检出率分别为3．2％和0．5％；其他疾患检出率12．9％，其高血压检出率9．5％。结论 宝山区铬接触工人中铬职业危害依然存在，应加强防护设施和个体防护，并加强卫生宣传教育和职业健康监护。     

Adult-age Kawasaki disease]

The clinical history of a 65-years-old man is described by authors with typical symptoms of the Kawasaki disease. The clinical picture of this syndrome is characterized by high fever, characteristic changes of mucous membrane and skin and enlargement of cervical lymph nodes. The disease is most frequent in Japan and very rare after the age of eighteen. The specific features of the case is emphasized in the adulthood and attention is drawn to the fact that their case is the oldest one in the literature.     

鼻内镜下鼻中隔棘／嵴突结构及其特征观察

目的观察鼻中隔棘／嵴突的基本结构和特征。方法回顾性分析我院2003年8月-2008年2月共616例行鼻中隔偏曲手术患者的鼻中隔棘／嵴突的基本结构．并结合其偏曲突起角度及有无鼻外伤史等因素对棘／嵴突进行临床分型。结果①鼻中隔棘／嵴突的基本结构可大致分为：骨性偏曲-对侧凹陷型（Ⅰ型）、偏曲侧骨质增厚型（Ⅱ型）、骨-软骨重叠型（Ⅲ型）、骨-软骨混杂型（Ⅳ型）及软骨部偏曲型（Ⅴ型）。②第Ⅲ、Ⅳ型者手术中黏膜破损率最高（共33％）,而第Ⅰ、Ⅴ型最低（共5．4％）。③第Ⅲ、Ⅳ型者中有鼻外伤史者比例最高（共84．9％）。④鼻中隔棘突最常出现于四方软骨与犁骨、筛骨垂直板三者交汇处（83．5％）;嵴突最常出现于四方软骨与上颌骨鼻嵴交界处（719％）。结论①鼻中隔棘／嵴突基本结构可大致分为五型,手术操作难易程度及术中黏膜破损率的高低与其不同类型有关。②鼻外伤是部分鼻中隔偏曲发生的原因之一。③鼻中隔棘／嵴突多位于鼻中隔各组成部分间的交汇处。     

鼻内镜下鼻中隔棘/嵴突结构及其特征观察

目的观察鼻中隔棘/嵴突的基本结构和特征。方法回顾性分析我院2003年8月～2008年2月共616例行鼻中隔偏曲手术患者的鼻中隔棘/嵴突的基本结构,并结合其偏曲突起角度及有无鼻外伤史等因素对棘/嵴突进行临床分型。结果①鼻中隔棘/嵴突的基本结构可大致分为:骨性偏曲-对侧凹陷型(I型)、偏曲侧骨质增厚型(II型)、骨-软骨重叠型(III型)、骨-软骨混杂型(IV型)及软骨部偏曲型(V型)。②第III、IV型者手术中黏膜破损率最高(共33%),而第I、V型最低(共5.4%)。③第III、IV型者中有鼻外伤史者比例最高(共84.9%)。④鼻中隔棘突最常出现于四方软骨与犁骨、筛骨垂直板三者交汇处(83.5%);嵴突最常出现于四方软骨与上颌骨鼻嵴交界处(71.9%)。结论①鼻中隔棘/嵴突基本结构可大致分为五型,手术操作难易程度及术中黏膜破损率的高低与其不同类型有关。②鼻外伤是部分鼻中隔偏曲发生的原因之一。③鼻中隔棘/嵴突多位于鼻中隔各组成部分间的交汇处。