CAJ | 학술논문

目的探讨使用利多卡因对医院获得性肺炎（HAP）患者经纤维支气管镜（简称纤支镜）收集支气管灌洗液（BLF）培养铜绿假单胞菌（PA）的阳性率及其药物敏感的影响。方法收集135例HAP患者BLF ，共270份BLF标本；对HAP患者进行纤支镜检查时，先在右侧分泌物较多的支气管直接收集BL F送细菌培养作为对照组；随后于左侧分泌物较多的支气管注入2％利多卡因3 mL局部麻醉后收集BLF送细菌培养作为利多卡因组，比较两组PA阳性率及药敏情况。结果对照组BLF培养 PA阳性42例，利多卡因组BL F培养PA阳性40例，两组PA培养阳性率分别为31．11％和29．63％，两组样本的PA培养结果一致性很高（ P＜0．001）；利多卡因组对环丙沙星、左氧氟沙星的PA敏感菌株少于对照组、耐药菌株多于对照组，差异均有统计学意义（P＜0．05），但对哌拉西林/他唑巴坦、头孢他啶等无影响。结论2％利多卡因不影响肺部感染患者BLF培养 PA的阳性率；会降低环丙沙星、左氧氟沙星对PA的敏感性。
목적탐토사용리다잡인대의원획득성폐염（HAP）환자경섬유지기관경（간칭섬지경）수집지기관관세액（BLF）배양동록가단포균（PA）적양성솔급기약물민감적영향。방법수집135례HAP환자BLF ，공270빈BLF표본；대HAP환자진행섬지경검사시，선재우측분비물교다적지기관직접수집BL F송세균배양작위대조조；수후우좌측분비물교다적지기관주입2％리다잡인3 mL국부마취후수집BLF송세균배양작위리다잡인조，비교량조PA양성솔급약민정황。결과대조조BLF배양 PA양성42례，리다잡인조BL F배양PA양성40례，량조PA배양양성솔분별위31．11％화29．63％，량조양본적PA배양결과일치성흔고（ P＜0．001）；리다잡인조대배병사성、좌양불사성적PA민감균주소우대조조、내약균주다우대조조，차이균유통계학의의（P＜0．05），단대고랍서림/타서파탄、두포타정등무영향。결론2％리다잡인불영향폐부감염환자BLF배양 PA적양성솔；회강저배병사성、좌양불사성대PA적민감성。
Objective To investigate the influence of application of local anesthesia with lidocaine on bronchial lavage fluid (BLF) pseudomonas aeruginosa culture and drug sensitivity in cases with lung infection .Methods Two hundred and seventy speci-men of BLF were collected from 135 patients with infection of lung .And BLF were collected directly from right-broncho in control group ,and from left-broncho in lidocaine group .The outcome of pseudomonas aeruginosa culture and drug sensitivity were com-pared in the two groups .Results Fourty-two cases were postitive in BLF pseudomonas aeruginosa culture in the control group ,and 40 cases were postitive in lidocaine group .The positive rates were 31 .11% and 29 .63% ,respectively .There were no significance between the two groups (P<0 .001) .Compared with the control group ,the sensitive strains of pseudomonas aeruginosa were obvi-ously less and the drug tolerance strains were much more in lidocaine group for Ciprofloxacin and Levofloxacin (P<0 .05) .Howev-er ,there were no influence for drugs such as Piperacillin/Tazobactam and Ceftazidime ,etc .Conclusion 2% lidocaine has no influ-ence on the outcome of BLF pseudomonas aeruginosa culture .But it may reduce the drug sensitivity of Ciprofloxacin and Levofloxa-cin in cases with infection of lung .