利多卡因对支气管灌洗液铜绿假单胞菌的影响研究  

Effect of lidocaine on pseudomonas aeruginosa in bronchial lavage fluid

作　　者：张九进[1,2] 黄翠娟[1,2] 张勇昌[1,2] 杨纯爱[1,2] 梁宇峰[1,2] 陈显源[1,2] 陈月新[1,2] 

机构地区：[1]广西玉林市第一人民医院 [2]广西医科大学第六临床医学院呼吸内科,537000

出　　处：《重庆医学》2013年第21期2466-2467,2469,共3页Chongqing medicine

基　　金：玉林市科学研究与技术开发计划项目(11042042)

摘　　要：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BLF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3mL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BLF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。Objective To investigate the influence of application of local anesthesia with lidocaine on bronchial [avage 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 Pourty-two cases were postitive in cases were postitive in lidoeaine 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 Cdtazidime, 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.

关 键 词：利多卡因 纤维支气管镜 支气管灌洗液 医院获得性肺炎 铜绿假单胞菌 

分 类 号：R446.5[医药卫生—诊断学]