Sticky phlegm of coal dust or cholesterol crystals
Introduction
Introduction The adhesion of coal dust or cholesterol crystals is a symptom of the clinical manifestations of coal workers' pneumoconiosis. Coal miner's pneumoconiosis refers to the general term for lung lesions caused by coal mine workers' long-term inhalation of dust in the production environment. According to the different time of contact with coal dust, the general anatomical appearance of the simple coal worker's pneumoconiosis is also different. Usually, there is no abnormality in the lung except for melanin on the surface of the pleura. Unless there is chronic bronchitis, there is no obvious abnormality in the trachea and bronchus.
Cause
Cause
(1) Causes of the disease
Coal is deposited from decaying plants in the marshes. Geographical conditions cause plants to undergo chemical changes due to high pressure and high temperature. Different types of coal are produced under different geographical conditions. After about 250 million years of experience, the peat gradually turns into lignite, which is converted into bituminous coal, and finally anthracite is formed. The origin of coal is closely related to sedimentary rock layers such as sandstone, mudstone, shale, silt, refractory stone and limestone. Due to different rocks, the dust composition of different coal mines or different coal seams of the same coal mine is different. The free silica contained in the coal itself is usually very low, but there may be a small amount of other associated minerals. The dust content in the air is different when the same coal mine exploits different rock formations. In the process of coal mine production, there are both coal dust and dust. At the same time, there have been different opinions on the role of the two. At first, it is believed that coal dust is only in the lungs, so-called coal dust pneumoconiosis. Sexual change is caused by dust in coal dust. Later, some dock workers who were engaged in coal unloading work saw that there was progressive bulk fibrosis in addition to coal dust. Therefore, it is believed that coal dust itself can cause pneumoconiosis.
(two) pathogenesis
The basic lesions of the coal under the microscope include coal dust (or coal spots, 5 mm pigmentation), pericardial emphysema or interstitial diffuse fibrosis. Coal dust and macrophages that have swallowed coal dust accumulate in the alveolar space, alveolar wall, bronchi and perivascular tissues, forming coal dust and coal dust cell foci, mostly around the secondary respiratory bronchioles. As the lesion progresses, irregularly arranged reticular fibers appear, and a small amount of collagen fibers can be interwoven in the later stage to form a coal dust fiber stove. There is emphysema in the stove, which is one of the main pathological features of coal workers' pneumoconiosis. Different degrees of fibrous tissue hyperplasia can be seen in the pulmonary interstitium.
In addition to the basic pathological changes of coal lung and silicosis, there are still pathological changes in the presence of coal dust and whisky, that is, the formation of coal gangue mixed nodules. In addition to reticular fiber hyperplasia in the nodules, collagen fibers are interwoven, but the latter are irregularly arranged, with coal dust cells and quartz particles in the nodules. Large fibrotic lesions can be seen in the advanced stage. Other features include subpleural coal dust deposition, hilar and mediastinal lymphadenopathy, and parietal pleural changes due to coal dust.
Examine
an examination
Related inspection
Pulmonary examination of lung function
First of all, pay attention to the duration of exposure to dust and occupational history. Generally developed as a simple coal worker's pneumoconiosis, the dust collection time in the well is 10 to 12 years. There is usually no abnormal change in lung function during this period. Clinical manifestations are non-specific. Early symptoms are often asymptomatic, and symptoms may only appear in patients with bronchitis or pulmonary infection. Cough, usually a mild dry cough, but the prevalence of chronic bronchitis in coal workers is higher, and cough is common in miners. When combined with pulmonary infection, the cough is aggravated, accompanied by cough, and it can cough up the sticky sputum containing coal dust or cholesterol crystals, and there is little hemoptysis. Most of the coal worker's pneumoconiosis patients have different degrees of chest tightness or chest pain, which is characterized by intermittent pain or acupuncture pain, which is more obvious after labor or cough. Sudden severe chest pain accompanied by difficulty breathing, should consider the possibility of spontaneous pneumothorax, gradually progressive difficulty in breathing difficulties. In some cases, the respiratory symptoms are not commensurate with the X-ray findings. The X-ray films are mild, but the acute symptoms are very serious.
Diagnosis
Differential diagnosis
Different diseases represented by different traits can be roughly divided into the following types:
White viscous sputum: mostly transparent sputum or slightly white, thin, usually caused by cold or mild bronchitis, healthy human body will also have a small amount of white sputum.
Yellow purulent sputum: due to pulmonary purulent infection, usually secondary infection caused by pneumonia, bronchitis, lung abscess or bronchiectasis, relatively thicker than white visceral sputum inflammation.
Yellow-green cockroach: caused by a special kind of bacteria, Pseudomonas aeruginosa. The appearance of this color should go to the hospital as soon as possible to find out the cause.
Rust-like sputum: The sputum of the lobar pneumonia is rust-like, with symptoms such as difficulty in breathing and chest pain, mostly caused by pneumococci, staphylococcus and pneumonia.
Bloody sputum: bloody sputum can be divided into several situations: one is with red bloodshot in the sputum, more common in tuberculosis or bronchiectasis, sometimes this can occur when there is inflammation in the pharynx; the second is black blood sputum, more common in Pulmonary infarction; third, pink foamy sputum, found in pulmonary edema. In addition, if you take it for a long time
