ABSTRACT
<p><b>OBJECTIVE</b>To preliminary study the long term therapeutic effects of repeat the whole lung lavage (RWLL) in the treatment of silicosis.</p><p><b>METHODS</b>A total of 60 patients with silicosis in the same stone mine were randomly and equally divided into repeat the whole lung Lavage (RWLL) group and whole lung Lavage (WLL) group based on silicosis staging, age and working age of dust exposure. Comparative analysis was performed to evaluate the long-term therapeutic efficacy and safety of RWLL. The cell count and SiO2 content were measured in twice right lung bronchoalveolar lavage fluid(BALF) of the RWLL group.</p><p><b>RESULTS</b>Four years after treatment, the cough and asthma improvement rates of the RWLL group were 68.4% and 75.0% higher than those (52.4%and 57.9%) of the WLL group (P > 0.05). Six years after treatment, the asthma improvement rate (70.0%) of the RWLL group was significantly higher than that (36.8%) of the WLL group (P < 0.05). The RWLL group showed slight decrease in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1.0) after treatment (P > 0.05), while the WLL group showed significant decrease in FVC and FEV1.0 in the six years after treatment (P<0.05). Four and Six years after treatment, the RWLL group had higher no change rate and lower progression rate and significant progression rate than the WLL group in terms of chest X-ray (P>0.05). In the RWLL group,the first time the right lung BALF test showed a number of cells 6.71×10(7)∼2.14×10(9)/L, average 4.50×10(8)/L, pulmonary alveoli macrophages (PAM) ratio of 0.873∼0.980, average 0.954 and SiO2 content of 18∼104.7 mg, average 93.7 mg; the second test showed a number of cells 5.71×10(6)∼1.30×10(9)/L, average 9.12×10(7)/L; PAM ratio 0.710∼0.926, average 0.870 and SiO2 content of 6∼90.2 mg, average 46.2 mg. The RWLL group happened hemoptysis, chest pain one case in perioperative period, the incidence of 6.7%. The RWLL group complicated by left pneumothorax, pulmonary infection one case and the WLL group complicated by one case of lung cancer in a year of follow-up.</p><p><b>CONCLUSION</b>RWLL is reasonable and safe treatment which could help to further improve the long-term effects of WLL for silicosis.</p>
Subject(s)
Adult , Humans , Male , Bronchoalveolar Lavage , Silicosis , Therapeutics , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the long-term therapeutic effect of whole lung lavage (WLL) in the treatment of silicosis.</p><p><b>METHODS</b>A total of 70 patients with silicosis were randomly and equally divided into WLL group and control group based on chest X-ray, silicosis staging, age, and working age of dust exposure. Comparative analysis was performed to evaluate the long-term therapeutic effect of WLL. Moreover, 157 patients with silicosis treated by WLL were subject to long-term follow-up.</p><p><b>RESULTS</b>Two years after treatment, the cough, expectoration, and asthma improvement rates of the WLL group were 62.5% , 75.0% , and 81.8%, respectively, significantly higher than those (24.0%, 23.8%, and 26.3%) of the control group (P < 0.05). Four years after treatment, the asthma improvement rate (59.1%) of the WLL group was significantly higher than that (21.1%) of the control group (P < 0.05). The WLL group showed slight decrease in forced vital capacity (FVC) and forced expiratory volume in one second (FEV(1)) after treatment (P > 0.05), while the control group showed significant decrease in FVC and FEV1 after treatment (P < 0.05 or P < 0.01). Two and four years after treatment, the WLL group had higher no change rate and lower progression rate and significant progression rate than the control group in terms of chest X-ray (P > 0.05). 22 cases of accelerated silicosis in the WLL group had significantly higher no change rate than the control group with respect to chest X-ray (75.0% vs. 30.0%; 58.3% vs. 20.0%). The WLL group had lower progression rate (2 years of treatment) and significant progression rate (4 years after treatment) than the control group (16.7% vs. 50.0%, P < 0.05; 8.3% vs. 30.0%, P < 0.05). Follow-up of 59 cases treated by WLL showed that the cough and asthma improvement rates were 74.4% and 76.3% 2 ∼ 3 years after treatment and remained 55.0% ∼ 57.1% 4 ∼ 5 years and 6 ∼ 7 years after treatment. Follow-up of 85 cases treated by WLL showed that FVC remained unchanged or slightly decreased 2 ∼ 3 years after treatment and decreased 4 ∼ 5 years and 6 ∼ 7 years after treatment and that the lower silicosis stage was, the less FVC decreased. Follow-up of 108 cases treated by WLL showed that the lower silicosis stage was, the higher no change rate was, according to the chest X-ray findings 2 ∼ 3, 4 ∼ 5, and 6 ∼ 7 years after treatment and that there were significant differences in no change rate between stages II and III silicosis groups and stages 0+ and I silicosis groups (P < 0.01).</p><p><b>CONCLUSION</b>WLL is an effective therapy for silicosis, especially for early silicosis and accelerated silicosis. However, WLL should be used cautiously in the treatment of advanced silicosis.</p>