Organophosphates: isicelo, amanyathelo neempawu umgaqo. Ityhefu Organophosphate, zoncedo lokuqala

Organophosphates iindidi amachiza, leyo eyenzelwe ukuba ukubulala ukhula, izinambuzane kunye nezikrekrethi.

Ezi zinambuzane ezisetyenziswa kuphela kwezolimo kodwa kubomi bemihla ngemihla. iintlobo ezininzi Austral inetyhefu kwaye kungabangela ityhefu esinzulu nokudla zombini ngaphakathi emzimbeni kwaye ukuqhagamshelana isifo ngeempumlo neliso, nkqu kunye nesikhumba lomelele.

Statistics Austral ubuthi

ukunxila Acute ngu iikhompawundi ze-enyanisweni kuthatha indawo yokuqala phakathi kwezinye ityhefu zithe zadala kuphela womxhuzulane kodwa rhoqo. Lethality loo Ityhefu yi phantse-20%, lo gama nezihlandlo - malunga ne-15% yazo zonke iimeko ukunxila. Of umdla kukuba na ebubuvuvu loo bokuhlala ukuba ityhefu organophosphate na utywala. Xa izigulane ababenze imo kunxilwe kakhulu ngexesha yingozi zinambuzane, esi sifo kulula kakhulu (unditsho kunye paresis kwemisipha nokuphefumla azifumaneki). Noko ke, ukuphazamiseka hemodynamic inokuba ucaca ngakumbi.

Izizathu ezinokwenzeka ubuthi zinambuzane

Organophosphate Ityhefu inokuba ngenxa emsebenzini kwaye kwenzeka ngenxa yokuphatha kabi izinto eziyityhefu. Kukungakhathali umntu omnye okanye ngaphezulu kungabangela ityhefu ezimandundu kungekho kubo kuphela, kodwa kwakhona kusenokukhokelela ukunxila abaninzi.

Ukongeza koku, yityhefu ngu iikhompawundi ze-nga zinganxitywa uhlobo ngemihla. Ubangelwa iingozi kunokuba ezahlukeneyo, umzekelo:

• Akukho mpawu kwizikhongozeli ulwelo enobuhlungu, zigcinwe ekhaya (umntu athathe ityhefu ngaphakathi ngempazamo okanye ngabom ngenjongo kunxilwe);
• ukugcinwa zinambuzane kwi ukufikelela kwabantwana (abantwana ngokwemvelo ukwazi kakhulu, kwaye nokuba sikhongozeli amachiza ayityhefu uza kusayinwa, umntwana omncinci lisenako ukusela ulwelo enobungozi kwaye Ityhefu oyingozi);
• Ukungaphumeleli ukuthobela imiqathango yokhuseleko (ukungahoywa kuthetha yokhuseleko xa kusetyenziswa izinto zekhaya ityhefu, ezifana isigqumathelo njengothuli, iiglavu, izibuko, impahla ekhuselayo).

Xa compound ze-ngeedosi ezinkulu kuwa phakathi komzimba womntu, zinokubangela emathunjini abantu kwiindawo ezahlukeneyo e-nervous system central ekhokelela neuritis, ukukhubazeka kunye neminye imiphumo emibi, kuquka ukufa.

Ukuhlelwa iikhompawundi ze-on ubuthi

• i iyityhefu - based zinambuzane thiophos, Metaphos, merkaptofosa, octamethyl;
• yityhefu - amachiza ezisekelwe demeton-s-imethyl, phosphamide, dichlorophosphate;
• srednetoksichnye - trichlorfon, malathion, metilnitrofos kunye izinambuzane ezisekelwe phezu kwabo, kwakunye sayfos, cyanophos, tribufos;
• zineqondo letyhefu - demufos, bromophos, temephos.

Iimpawu yingozi Austral

Ngokutsho neqondo yityhefu womxhuzulane zahlulwe ngezigaba-3. Clinic organophosphate Ityhefu lumi ngolu hlobo lulandelayo:

ukunxila Mild (I sigaba):

• lengqondo yokususa imvakalelo yoloyiko;
• ukuphelelwa umoya;
• abafundi inimba (miosis);
• intlungu yiSpasticity esiswini;
• anda izinkcwe kunye nokugabha;
• enentloko engapheliyo;
• uxinzelelo lwegazi oluphezulu;
• ukubila lweenkcukacha;
• kwesifuba.

Xa uhlobo oluphakathi (isigaba II):

• ukuphazamiseka zigcinwe okanye ngokuthe ngcembe indawo inhibition, yaye ngamanye amaxesha - kwaye isiqaqa;
• miosis esiphawuliweyo, umfundi ukuba ukukhanya uyasilela ukuphendula;
• kakhulu ukubonakalisa iimpawu hyperhidrosis (nkulu izinkcwe (ngamathe), ukubila, bronhoreya (phlegm ukusuka bronchi));
• fibrillar twitching Neenkophe, izihlunu esifubeni, imilenze, yaye ngamanye amaxesha zonke izihlunu;
• imbonakalo periodic izihlunu zomzimba iyonke ehleliyo, yombono tonic;
• kunyusa ithoni esifubeni;
• uxinzelelo lwegazi ufikelela yokusebenza iphezulu (250/160);
• defecation ngokuzenzekelayo kunye ukuchama, ekhatshwa tenesmus kabuhlungu (iminqweno bobuxoki).

Ityhefu ezimandundu (isigaba III):

• isigulane iwela isiqaqa obukhulu;
• Zonke ikhaliphe ukuba buthathaka okanye engekho ngokupheleleyo;
• hypoxia kakhulu;
• libizwe miosis;
• ukugcinwa iimpawu hyperhidrosis;
• ukutshintsha hypertonus dystrophy, miofibrillyatsii kunye unditsho tonic kofe umzimba izihlunu kuthanjiswa;
• Ubunzulu internal odandathekileyo ngamandla kwaye rhoqo phefumla abangaphumi, kunokwenzeka ekukhubazekeni yokuphefumla;
• izinga intliziyo uvikivwa nezibonisi ezibalulekileyo (40-20 imiz.);
• tachycardia oluphuculweyo (ibetha ngaphezu kwe 120 imiz nganye.);
• uxinzelelo lwegazi iyaqhubeka kuwa;
• asakhasayo Encephalopathy eyityhefu kunye nokudumba kunye hemorrhages diapedetic ezininzi uhlobo kukhethwa engumxube, ngenxa ukushwabana izihlunu bokuphefumla inhibition kweziko sokuphefumla;
• isikhumba umngena kubuna kubonakala cyanosis (isikhumba kunye imifinya yangaphakathi zibe umbala oluhlaza).

Imiphumo zinambuzane ityhefu phosphorus

Xa umzimba kuwa iikhompawundi ze-, zoncedo lokuqala ezinikezelwa ngokukhawuleza kwaye ngokufanelekileyo, yenye yezinto ezibalulekileyo ezibonakalisa indlela ngakumbi esi sifo. Austral ukunxila okanye uphethwe lula ngokwentelekiso ukwambatha umfanekiso lwezonyango iimpawu, Noko ke, kukuba ingaba kwisiphumo evumayo okanye ixhoba esifa, kuxhomekeke kakhulu ezilandelayo-up zonyango.

Ngenxa ubuthi aphezulu iikhompawundi ze-xa tapeworm umonakalo noqhekeko phantse onke amalungu abalulekileyo kunye neenkqubo. Kule meko, nkqu ukuba ayaphumelela ukubuyisela ngokupheleleyo umsebenzi wamalungu ezithile ziyasilela.

Phakathi iingxaki, nto leyo idla kunye ukunxila kabi iikhompawundi ze-ziquka inyumoniya, arrhythmias ezesifuba Uhanjiso kwentliziyo, ukugula ngengqondo iziyobisi-aqhubela ngendlela ebukhali, njl

isifo

Ngexa leentsku ezimbalwa emva kokuba yityhefu, isigulana zikwimeko embi okubangelwa yokuwa sentliziyo. Emva koko kuza imbuyekezo ngokuthe ngcembe yaye ngcono impilo. Noko ke, emva kweeveki 2-3, kunokwenzeka uphuhliso polyneuropathy kakhulu ityhefu. Kwezinye iimeko, le nkqubo inxaxheba eziliqela luvo cranial.

Ngexesha elizayo ezi polyneuropathy ngokwaneleyo elide, maxa wambi ephelekwa iingxaki intshukumo sizingise. Buyisela imisebenzi yenkqubo peripheral nervous kubi. Kusenokwenzeka kwakhona kwenzeka ukubuya ukuphazamiseka ludlule, ezifana nengxaki cholinergic. Isizathu kukuba ilahlwe ze-compound "betekisi" kwinyama ezahlukeneyo kwinkqubo kwegazi.

unyango

Xa kwimeko yityhefu esinzulu iikhompawundi ze-, zoncedo lokuqala kufuneka iquke ukucocwa ngxwaba wokugaya ngu lavage esiswini ngokusebenzisa uphenyo diuresis ngenkani, njl, ukugcinwa nokuphefumla kunye nokusetyenziswa antidotes ezithile. Ngaphezu koko, a entsokothileyo bazamile, kuquka pharmacotherapy, ejolise ukugcina nokubuyisela umzimba yonakele, kubandakanya amanyathelo ukubuyisela umsebenzi kwentliziyo, unyango ukuphazamiseka of homeostasis nokothuka exotoxic.

Ukubuyiselwa umsebenzi nokuphefumla

iikhompawundi ze-labanjwa emzimbeni kukuninzi, ngokuqhelekileyo kunokubangela unxunguphalo yokuphefumla, zibangelwa ngokugqithiseleyo secretion oropharyngeal, kunye bronchoconstriction ukushwabana izihlunu zemiphunga. Ngokuphathelele oku, into yokuqala oogqirha bazama ukwenza - kukuba ukubuyisela ngokuma nokuqinisekisa umoya ngokwaneleyo. Phambi vomitus intabalala kunye ukubhobhoza oropharyngeal, sisebenza njengeminqweno (lokuthathwa ulwelo yi cleaner). Ukonakalisa etsolo Austral bazamile ziquka ekumfakeni endotracheal, umoya ngomatshini.

therapy ikhubalo

safeners Application (antidotes) yinxalenye ebalulekileyo pharmacotherapy olungxamisekileyo ukonakalisa oyingozi. Iziyobisi kweli qela kuchaphazela kinetics ise umzimba izinto eziyityhefu, zinika Absorption yayo okanye ukuphelisa, isiphumo ephantsi receptors yoluvo ukunqanda lokugaya eziyingozi kunye nokuphelisa izifo ezinobungozi kwemisebenzi zomzimba ebalulekileyo, okubangelwa ukunxila.

Esiphilisa yityhefu ngu iikhompawundi ze-ethatyathwe kunye namanye amachiza ezizodwa. Pharmacotherapy ebanjwe ngaxeshanye kunye bazamile jikelele kunye namanyathelo detoxifying nezinyangayo.

Kufuneka kukhunjulwe ukuba akukho amathuba bazamile ngokukhawuleza, ubomi yexhoba asindiswe iikhompawundi kuphela iyeza ze-, yaye kungekudala kokuba usiwe, ithuba elingcono ixhoba liya kuba isiphumo esihle esi sifo.

ngezigaba antidotes

Antidotes zihlelwa ngokwamaqela ezine:

• lingaze (imithi);
• eziphilayo (toxicokinetic);
• chemical (toksikotropnye);
• antitoxic Immunopreparat.

Xa iimpawu zokuqala yityhefu organophosphate, kodwa inyathelo dogospitalizatsii ixhoba, kwaye asebenzise ebubuvuvu amaqela toksikotropnoy kwangumqondiso, ekubeni icacile ukuba ukusetyenziswa. Amalungiselelo amanyathelo toxicokinetic ifuna ukubambelela ngokungqongqo imiyalelo, kuba oogqirha-ambulensi bangakwazi ukugqiba ngokuchanileyo izinto ezibonisa ukuba ukusetyenziswa kwazo. Antitoxic Immunopreparat wasebenzisa kwiziko lonyango.

unyango oluthile ityhefu etsolo ngu iikhompawundi ze-

iziganeko Complex iquka usebenzisa anticholinergics (amayeza uhlobo atropine) xa zidityaniswe kunye reactivator cholinesterase. Kwiyure yokuqala emva esibhedlele ziqhutywe atropine olunzulu. Atropine ngeedosi ezinkulu ilawulwa yegazi ukuya ukukhululeka iimpawu hyperhidrosis ekhoyo. Kufuneka kwakhona babe iimpawu libanda, iziyobisi amandla, wavakalisa isikhumba kunye tachycardia ngomlinganiselo.

Ukugcina le Ntetho atropine ilawulwa ngokuphindaphindiweyo, kodwa ngeedosi ezincinane. atropinization inkxaso idala kwafa zokungathotyelwa kweenkqubo m-cholinoreactive yonakele yomzimba intshukumo ukuchasa iziyobisi of acetylcholine kwixesha efunekayo ukutshatyalaliswa kunye nokupheliswa ityhefu.

cholinesterase Reaktivatory Modern bakwazi ukuqinisa ngempumelelo cholinesterase abacinezelekileyo yokungenelela iikhompawundi ezahlukeneyo phosphorus. Ekuphumezeni unyango oluthile ukugadwa umsebenzi rhoqo cholinesterase.