[The long-term therapeutic effects of silicosis by repeat the whole lung lavage].
OBJECTIVE
To preliminary study the long term therapeutic effects of repeat the whole lung lavage (RWLL) in the treatment of silicosis.


METHODS
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.


RESULTS
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.


CONCLUSIONS
RWLL is reasonable and safe treatment which could help to further improve the long-term effects of WLL for silicosis.
Nine department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing 210029, China.
Ying-ming
YM
Zhang
Wei
W
Wang
Cai-ying
CY
Wang
Hai-tao
HT
Zhang
Jing
J
Wu
Chun
C
Wang
Shen-cun
SC
Fang
D000328:Adult; D018893:Bronchoalveolar Lavage; D006801:Humans; D008297:Male; D012829:Silicosis / Q000628:therapy*; D016896:Treatment Outcome