伐木工人振動症狀群診斷方法的比較

A Comparative Study of Diagnostic Tests Vibration Syndrome among Forest Workers

林春蓮(Chuan-Lian Lin) ； 徐尚為(Shang-Wei Hsu) ； 劉紹興(Saou-Hsing Liou)

《Journal of Medical Sciences》 13卷6期 (1993/06) Pp. 387-396

摘要

由於振動作業勞工健康檢查缺乏一致的標準，且周邊循環或神經功能檢查結果往往與自覺症狀無法配合，本研究比較振動症狀群的三種檢查方法以探討檢查結果與病人自覺症狀的相關性。二年間分別選取78，44和31位蘭陽林區伐木工人為研究對象，分別進行對側手泡冰水，同側手泡冰水和同側手振動刺激等三種試驗，各種檢查問隔時間約半年至一年。檢查時記錄每位伐木工人手指接受刺激前與刺激後的指脈波，並求取每位檢查者的基準高度，刺激後下降百分比和回復到基準點的時間。上述檢查結果並與職業病醫師依泰勒氏分級表問診之”自覺症狀”比較。本研究發現對倒手泡冰水之試驗對白于病診斷較有價值，且其回復時間與自覺症狀的嚴重程度有相關，基準高度與下降百分比則與自覺症狀嚴重程度無關。但回復時間與鏈鋸使用總小時數無關。同側手泡冰水和同側手振動檢查結果則與自覺症狀的嚴重程度沒有相關。因此，對側手泡冰水檢查方法的回復時間可用做振動作業勞工之一種健康檢查方法，以預測振動症狀群的嚴重程度。

關鍵字

振動症狀群:指脈波記錄圖:回復時間

並列摘要

There was lack of standardized tests to evaluate the severity of vibration syndrome in vibration exposed workers. This study compared three provocation tests in order to evaluate the relationship between test results and the severity of vibration syndrome. forest workers, 78, 44, and 31 subjects were selected and examined separately within two years for the opposite hand immersed in ice water provocation test, the affected hand immersed in ice water provocation test and the affected hand stimulated by vibration provocation test. The time interval between the two tests was about one year. The plethysmogram of each participant was recorded before and after the provocation test. The baseline amplitude before challenge, percentage of decline of amplitude at the end of challenge and the recovery time were calculated from the plethysmogram. These results were tested for the association with Taylor's classification of vibration syndrome. The results showed that the opposite hand immersed in ice water was of best value for diagnosis of vibration syndrme, and the recovery time was associated with the severity of vibrtion syndrome. but the baseline amplitude and percentage of decline were not. However, the recovery time was not associated with hours of chainsaw using. The other two tests, the affected hand immersed in ice water and affected hand stimulated by vibration, were not associated with the severity of vibration syndrome. These findings suggested that the provocation test of the opposite hand immersed in ice water may be used in periodic health examination of vibration exposed workers to predict the severity of vibration-induced syndrome.

並列關鍵字

Vibration syndrome ； Plethysmogram ； Recovery time