救助政策实施利于农民工尘肺病患者治疗

目的分析政府救助政策对广西两县农民工尘肺病患者肺部健康的影响。方法通过查阅病案资料、乡村医生走访等回顾性调查方式,对比分析广西有救助政策的H县尘肺病患者(H组,90例)与无救助政策的M县患者(M组,87例)10年前后肺功能用力肺活量占预测值百分比(FVC%)、一秒用力呼气容积占预测值百分比(FEV1%)、一秒率(FEV1/FVC)、分型]、尘肺病分期及合并症变化情况。结果入选时(2010年),H组、M组尘肺病患者肺功能指标及分型、尘肺分期、合并症发生情况差异无统计学意义(P>0.05)。获救助后第10年(2020年),H组FVC%、FEV1%、FEV1/FVC分别为(91.44±11.00)%、(83.46±17.17)%、(74.32±10.27)%,无通气功能障碍者占60.0%,分别高于M组的(81.49±14.01)%、(75.12±21.64)%、(70.21±14.64)%,以及无通气功能障碍者的占比(35.6%),差异均有统计学意义(P<0.05)。与2010年相比,2020年H组壹期无人晋期,而M组壹期、贰期均有患者晋期,M组患者晋期人数占比高于H组(P<0.05)。2020年两县合并症的发生率差异有统计学意义(P<0.05);H组出现合并症的比例(62.2%)低于M组(89.7%)(P<0.05),其中M组肺炎、胸腔积液、多种合并症并存的比例更高(P<0.05)。结论实施救助政策能在一定程度上延缓尘肺病患者肺功能指标下降、通气功能障碍恶化、期别晋期及合并症的发生。提供政府救助措施,更有利于患者救治救助,全面保障劳动者职业健康权益。

Implementation of government medical rescue policies benefited treatment of migrant workers' pneumoconiosis

  Objective  To confirm the benefit effect of government medical rescue policies on improvement of treatment of migrant workers' pneumoconiosis in Guangxi.  Methods  Totally 90 pneumoconiosis patients in H County where medical rescue policies were implement since 2010 and 87 cases in M County where there were no rescue policies available were studied. Through retrospective investigation methods, such as consulting medical records and visiting rural doctors, the data of pulmonary function percentage of forced vital capacity in predicted value (FVC%), forced expiratory volume in one second in predicted value (FEV₁%), one second rate (FEV₁/FVC), and classification], pneumoconiosis stage and complications of these pneumoconiosis patients, before and after 10 years, were collected and compared.  Results  At the beginning in 2010, there were no significant differences of the pulmonary function indexes and classification, stage, complications between the patients in the two counties (P>0.05). Ten year after implementation of medical rescue policies(2020), FVC%, FEV₁% and FEV₁/FVC of patients in H county were(91.44±11.00)%, (83.46±17.17)% and (74.32±10.27)%, respectively, which were substantially better than those of patients in M county (81.49±14.01)%, (75.12±21.64)% and (70.21±14.64)%, respectively (P < 0.05). Compared with 2010, no one in H county in Phase I was promoted, while some patients in Phase I and Phase II in M county were promoted in 2020. The promotion rate of M county was higher than that of H county (P < 0.05). In 2020, the proportion of complications of patients in H County was 62.22% and lower than that of patients in M County(89.97%)(P < 0.05), while pneumonia, pleural effusion and multiple complications of patients in M County was more obvious (P < 0.05).  Conclusions  Implementation of medical rescue policies benefited, to some extent, the treatment of migrant workers' pneumoconiosis, mitigating the decrease of pulmonary function, the deterioration of ventilatory dysfunction, the progression of pneumoconiosis stage, and the occurrence of complications. The government's relief measures are conducive to the treatment and rescue of the migrant workers, and comprehensively protecting these workers' occupational health rights and interests.