OBJECTIVETo investigate the long-term therapeutic effect of whole lung lavage (WLL) in the treatment of silicosis.

METHODSA 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.

RESULTSTwo 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).

CONCLUSIONWLL 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.