Mr. Wang, 54 years old this year, went to the county hospital for treatment due to the pain in the right shoulder joint, patted the chest CT and found multiple nodules in the two lungs, and came to the Nanchang Hospital affiliated to Sun Yat-sen University for diagnosis and treatment. After inquiring about the situation, the doctor found that Mr. Wang had been engaged in wall cutting for more than ten years, the working environment was dusty, and the protective measures were not in place. After completing the examination, Mr. Wang was diagnosed with silicosis (stage I).
At present, silicosis lacks a cure, and large-volume total lung lavage combined with drug therapy is the best treatment option today. However, there is no precedent for large-capacity total lung lavage in our city during the same period of double lung.
After repeated multidisciplinary discussions in geriatrics, anesthesiology and operating room, Director Li Guangming performed large-capacity full-lung lavage therapy for both lungs at the same time.
The operation went very smoothly, and Mr. Wang recovered well after the operation, and he was discharged home on the 4th day. Large-volume total lung lavage in both lungs at the same time greatly shortens the patient's hospital stay, reduces the pain of endotracheal intubation and anesthesia, and reduces the patient's financial burden.
Mr. Wang's lungs washed out of the "sewage"
What is pneumoconiosis?
Pneumoconiosis is a systemic disease predominantly diffuse fibrosis (scarring) of lung tissue caused by long-term inhalation of productive dust (dust) during productive activities and retention in the lungs. There are twelve types of pneumoconiosis identified according to occupational diseases that need treatment: silicon lung, coal industrial lung, graphite pneumoconiosis, carbon ink pneumoconiosis, asbestos lung, talc pneumoconiosis, cement pneumoconiosis, mica pneumoconiosis, potter's pneumoconiosis, aluminum pneumoconiosis, welder's pneumoconiosis, and casting pneumoconiosis. Pneumoconiosis patients are mainly distributed in coal, nonferrous metals, machinery, building materials, light industry and other industrial industries.
Symptoms of pneumoconiosis
From inhalation of dust to the appearance of pneumoconiosis usually takes 8 to 10 years, before which there is no discomfort, like normal people, many patients are found during chest imaging or physical examination, so it is called a silent killer. In the advanced stages of pneumoconiosis, symptoms such as cough, dyspnea, fatigue, loss of appetite, and weight loss may occur. Pneumoconiosis is easy to combine respiratory infections, tuberculosis, COPD, lung cancer, pneumothorax, pulmonary heart disease, respiratory failure and other diseases, most pneumoconiosis patients are mostly diagnosed and treated in hospitals because of these complications, only to know that they suffer from this disease.
Treatment of pneumoconiosis
The treatment purpose of pneumoconiosis is mainly to treat and prevent various complications, and to delay the progression of pneumoconiosis, and there is no specific drug at present. Commonly used therapeutic drugs are gram silicone, hanfen hexanexin, aluminum preparations, and proprietary Chinese medicines such as chuanqiazine, danshen ketone injection and so on. Large-volume full-lung lavage is currently the most effective treatment and is suitable for patients with recent exposure to a large amount of dust and pneumoconiosis below stage II.
Full lung mass lavage
The full-lung mass lavage technique is a bilateral lung separation performed with a double-lumen bronchial catheter under total anesthesia. Ventilator-assisted single-lung ventilation to maintain pulmonary ventilation required for metabolism is repeatedly flushed with normal saline at 37 °C. Through large-capacity total lung lavage, the causative factors such as dust, inflammatory cells, and cytokines in the lungs can be cleansed out, so as to improve lung function, slow down the development of lesions, delay disease progression, and improve life and quality of life. Total lung lavage is suitable for the treatment of pneumoconiosis, alveolar protein deposition, inhalation of toxic substances, inhalation of harmful liquids (such as gasoline, etc.), severe or refractory lower respiratory tract infections, chronic state of asthma and other diseases.
Expert Profiles
Li Guangming
Director of the Department of Geriatrics, Nanchang Hospital affiliated to Sun Yat-sen University
Doctor of Medicine, Chief Physician
Professor, master's supervisor
Specialty: diagnosis and treatment of common respiratory diseases and elderly diseases such as lung infections, chronic obstructive pulmonary diseases, pulmonary heart diseases, bronchial asthma, bronchiectasis, thoracic diseases, interstitial lung diseases, pneumoconiosis, chronic cough, pulmonary embolism and other common diseases of the respiratory system. He is good at the rescue of respiratory emergencies such as hemoptysis, pulmonary encephalopathy, and expiratory disease. Proficiency in the use of invasive and noninvasive ventilators, large-volume total lung lavage, comprehensive assessment of the elderly, bronchoscopic interventional diagnosis and treatment, and percutaneous lung puncture.
Outpatient hours: Every Friday morning 8:00-12:00 a.m
Contributed by: Department of Geriatrics, Nanchang Hospital, Sun Yat-sen University
Correspondent: Zhang Jingjin
Editor: Huang Menglin Zhou Yun