Prognostic factors of the efficiency of valve bronchial block in patients having destructive tuberculosis and low motivation for treatment
Objective: To estimate factors influencing healing of the pulmonary tumor cavitation in case of valve bronchial block (VBB) among patients having tuberculosis and low motivation to take anti-tuberculosis medicines. Methods: 135 patients having destructive tuberculosis and low motivation for treatment were studied according to factors influencing the effectiveness of VBB. Depending on the results two groups of patients were defined: patients with healing (n=78) and patients whose pulmonary tumor cavitation stayed at the same level (n = 56). Results: The method turned out to be the most effective for patients having the duration of the disease for less than 2 years, upper-lobe localization of tuberculosis process with the pulmonary tumor cavitation up to 2 cm, bacteriologically proven, having HIV co-infection with the concentration of CD4+-lymphocytes in blood in the amount of more than 250 cells per microliter and committed to antiretroviral therapy and also among patients with the periodic anti-tuberculosis chemotherapy take offs after treatment restarting. Conclusions: Such factors as tuberculosis anamnesis for longer than 2 years, 4-7 cm cavitation, remaining mild or abundant bacterioexcretion, wide drug resistance of the pathogen, the level of CD4+-lymphocytes in blood less than 250 cells per microliter for HIV co-infected, and total rejection of anti-tuberculosis drugs influence the maintaining of the destructive changes on the basis of VBB.