Organophosphates: isicelo, izinyathelo kanye izici isimiso. ubuthi Organophosphate, usizo lokuqala

Organophosphates kukhona amakhemikhali izigaba, okuyinto zenzelwe ukubulala ukhula, izinambuzane namagundane.

Lezi zinambuzane kabanzi hhayi kuphela emkhakheni wezolimo kodwa futhi ekuphileni kwansuku zonke. izinhlobonhlobo eziningi Fos anobuthi kakhulu futhi kungabangela ubuthi obungathi sína ngokuthatha ukungenisa kokubili ngaphakathi emzimbeni futhi nabo mucosa acinene futhi iso, ngisho ne isikhumba njengoba yayinjalo.

Izibalo Fos ubuthi

ukudakwa olunamandla ngu organophosphorus compounds eqinisweni ithatha nendawo ephambili phakathi kwezinye ubuthi exogenous adonsela phansi nje kuphela kodwa futhi by imvamisa. Lethality ubuthi enjalo kucishe 20%, ngesikhathi ukuvama --15% azo zonke izimo lokudakwa. Okuthakazelisayo yokuthi ikhubalo eyinqaba ngoba ubuthi organophosphate kuyinto utshwala. Ezigulini zazisesimweni esibi lokudakwa kakhulu ngesikhathi ushevu ngesibulali-zinambuzane, lesi sifo singumbulali lula kakhulu (Ukudlikizela futhi paresis kwemisipha yokuphefumula kungukuthi etholakalayo). Nokho, izinkinga hemodynamic kungenzeka evelele.

Ezinye izinto okungenzeka ubuthi ngesibulali-zinambuzane

Organophosphate ubuthi kungenzeka kubangelwa emsebenzini zenzeka ngenxa handling engafanele ezinobuthi. Ukunganaki somuntu oyedwa noma ngaphezulu kungaholela hhayi kuphela ubuthi sina bona, kodwa futhi kuholele ukudakwa mass.

Ngaphezu kwalokhu, ubuthi by organophosphorus compounds kungenziwa igqoke imvelo kwansuku zonke. Izimbangela izingozi kungaba ezahlukene, isibonelo:

• akukho izimpawu eemumathini nge ketshezi enobuthi, egcinwe ekhaya (umuntu angathatha Ubuthi ngaphakathi ngephutha noma ngamabomu ngenjongo lokudakwa);
• isitoreji zinambuzane e kude nezingane (izingane ngemvelo curious kakhulu, futhi ngisho noma esitsheni amakhemikhali anobuthi izonikwa, ingane encane usengakwazi baphuze ketshezi enobungozi kanye ubuthi acute);
• ukwehluleka ukuhambisana nemithetho ukuphepha (ukunganakwa kusho yokuvikela uma lisetshenziswe yasendlini anobuthi izinto, ezifana uthuli buso, amagilavu, amagogolo, izingubo ezivikelayo).

Lapho kwakwakhe organophosphorus ngemithamo ezinkulu kuwela ngaphakathi emzimbeni womuntu, bona kungabangela izilonda izingxenye ezahlukene isimiso sezinzwa esiyinhloko ukuthi kuholela neuritis, ukukhubazeka kanye nezinye nemiphumela engathi sína, kuhlanganise nokufa.

Ukwahlukanisa organophosphorus compounds phezu ubuthi

• kwesinobuthi kakhulu - based zinambuzane thiophos, Metaphos, merkaptofosa, octamethyl;
• ezinobuthi - izidakamizwa esekelwe demeton-s-methyl, phosphamide, dichlorophosphate;
• srednetoksichnye - trichlorfon, malathion, metilnitrofos kanye zinambuzane okusekelwe kuyo, kanye sayfos, cyanophos, tribufos;
• ongaphakeme-ubuthi - demufos, bromophos, temephos.

Izimpawu ushevu Fos

Ngokwe-degree ubuthi gravity zihlukaniswe izigaba 3. Umtholampilo organophosphate ubuthi simiswe ngalendlela lelandzelako:

ukudakwa okuncane (mina nesigaba):

• lengqondo yokususa uthuthuva babenakho ukwesaba;
• iphika;
• abafundi osuke usuvulekile (miosis);
• ubuhlungu spastic esiswini;
• anda amathe nokuhlanza;
• izinhlungu zekhanda ezinamandla;
• umfutho wegazi ophakeme;
• ukujuluka kakhulu;
• kwesifuba.

Ngezinye ifomu ngokulinganisela (II esiteji):

• ukuyaluza zigcinwe noma kancane kancane indawo okusithiyayo, futhi ngezinye izikhathi - futhi equlekile;
• miosis ngokuphawulekayo, umfundi ukukhanya bengasabeli;
• Ubuningi bamahora sibonakalise izimpawu hyperhidrosis (ikhulisiwe amathe (ngamathe), ukujuluka, bronhoreya (phlegm kusukela bronchi));
• fibrillar ukunyakazisa nezinkophe, imisipha yesifuba, imilenze, ngezinye izikhathi yonke imisipha;
• ukubukeka ngezikhathi Imininingwane imisipha nomzimba Hyper, Ukudlikizela tonic;
• kakhulu kwandisa ithoni kwesifuba;
• umfutho wegazi ifinyelela ukusebenza esiphezulu (250/160);
• sokuzikhulula okungalindelekile futhi ukuchama, ephelezelwa tenesmus ubuhlungu (izifiso amanga).

ubuthi Sinzima (III esiteji):

• isiguli iwela equlekile ejulile;
• Zonke elisheshayo buthaka noma ngingekho ngokuphelele;
• hypoxia ezinzima;
• liphinyiselwe miosis;
• kulondolozwe izimpawu hyperhidrosis;
• ushintsho hypertonus kwemisipha, miofibrillyatsii kanye nokugoqana tonic kofé uhlangothi muscle;
• kakhulu ecindezelekile kwezimila ukujula kanye nokuvama umoya kuthiwa okungajwayelekile, kungenzeka ukukhubazeka zokuphefumula;
• kwenhliziyo ubizwa sehliselwe izinkomba esibucayi (40-20 imiz.);
• tachycardia sithuthukiswe (angaphezu kuka-120 amabhithi imiz ngayinye.);
• umfutho wegazi uyaqhubeka bawe;
• ekuthuthukiseni encephalopathy anobuthi ne edema nokopha diapedetic eziningi uhlobo okungcono okuxubile, ngenxa ukukhubazeka kwemisipha yokuphefumula kanye okusithiyayo isikhungo zokuphefumula;
• isikhumba evele fade livela cyanosis (isikhumba kanye nolwelwesi lwamafinyila ziba nombala bluish).

Imiphumela ubuthi phosphorus zinambuzane

Lapho umzimba iwe organophosphorus compounds, usizo lokuqala elihunyushwe ngokuthi ngokushesha futhi ngendlela efanele, ingenye izici eziyisisekelo ukucacisa Yiqiniso kwaleso sifo. Fos ukudakwa uphethwe lula ukubeka ku isici isithombe emtholampilo Nokho, kungakhathaliseki ukuthi umphumela kungenkathi evumayo noma isisulu efa, kuncike kakhulu eyalandela wezokwelapha.

Ngenxa ubuthi eliphezulu organophosphorus compounds lapho udle likulimaze ungalungiseki cishe zonke izitho ezibalulekile kanye nezinhlelo. Kule ndaba, ngisho umphumela omuhle ukubuyisa ngokugcwele umsebenzi kwezitho ezithile bayamdumaza.

Phakathi nezinkinga, okuyinto ngokuvamile uhambisana ukudakwa kabuhlungu organophosphorus compounds zihlanganisa i-pneumonia, arrhythmias inhliziyo futhi conduction inhliziyo, sengqondo izidakamizwa olubangelwa efomini acute, njll

lesi sifo

Ezinsukwini zokuqala ezimbalwa ngemva elinobuthi, isiguli usesimweni esibucayi kubangelwa ukuwohloka zenhliziyo. Bese kuba isinxephezelo akusheshi futhi kuthuthukisa impilo. Nokho, ngemva kwamasonto 2-3, kungenzeka ukuthuthukiswa okukhulu polyneuropathy anobuthi. Kwezinye izimo, le nqubo kungase kuhileleke eziningana izinzwa cranial.

Kulezi polyneuropathy kamuva ngokwanele isikhathi eside, ngezinye izikhathi zihambisana eziphikelelayo ukunyakaza iziyaluyalu. Buyisela nemisebenzi neuropathy isimiso sezinzwa kubi. Iphinde kungenzeka ukubuya iziyaluyalu acute, ezifana crisis cholinergic. Isizathu siwukuthi imali organophosphorus kwakwakhe "ukhiphe" ezicutshini ahlukahlukene ku isimiso sokujikeleza kwegazi.

ukwelashwa

Lapho kwenzeka ubuthi obungathi sína ngokuthatha organophosphorus compounds, usizo lokuqala kufanele zihlanganisa ukuhlanza nolaka ipheshana wokugaya ukudla by lavage esiswini usebenzisa uphenyo diuresis ophoqelelwe, njll, ukugcinwa kwezimila futhi ukusetshenziswa sinqobe ethize. Ngaphezu kwalokho, eyinkimbinkimbi yokusiza umuntu ukuba aphefumule, kuhlanganise pharmacotherapy, inqophe ukunina nokubuyisela ezilimele umzimba imisebenzi, okubandakanya izindlela ukubuyisela umsebenzi inhliziyo, ukwelapha izifo homeostasis futhi ukushaqeka exotoxic.

Ukubuyiselwa umsebenzi zokuphefumula

Organophosphorus compounds abanjwe emzimbeni izinto eziningi ezinkulu, ngokuvamile ibangela ukucindezeleka zokuphefumula, kubangelwa ngokweqile uketshezi oropharyngeal, futhi bronchoconstriction ukukhubazeka imisipha zokuphefumula. Ngokuqondene nalokhu, into yokuqala ukuthi odokotela ozama ukwenza - Iwukubuyisela umgudu kanye ukuqinisekisa komoya ohlanzekile okwanele. Ephambi kwezinduna vomitus obuningi futhi ocucuzayo oropharyngeal, osebenza nenshisekelo (edonsa uketshezi nge cleaner). Ngo ubuthi acute Fos yokusiza umuntu ukuba aphefumule zihlanganisa intubation endotracheal, ukupholisa lokukhanda.

yokwelapha isihlungu

safeners Isicelo (sinqobe) kuyingxenye ebalulekile pharmacotherapy eziphuthumayo ubuthi oyingozi. Izidakamizwa kuleli qembu kuthinte kinetics elise emzimbeni ezinobuthi, ukunikeza ukumuncwa kwayo noma ukuqedwa, umphumela ezansi ushevu receptor ukuvimbela ukugaya esiyingozi futhi kuqedwe izifo ezibangelwa enobungozi ebalulekile umzimba imisebenzi, kubangelwa ukudakwa.

Alikaziwa ikhambi lobuthi bama ubuthi by organophosphorus compounds kuthathwe kanye nezinye izidakamizwa ezikhethekile. Pharmacotherapy esiqhutshwa parallel yokusiza umuntu ukuba aphefumule jikelele kanye izinyathelo detoxifying zokwelapha.

Kumele kukhunjulwe ukuthi akukho kungenzeka yokusiza umuntu ukuba aphefumule ngokushesha, ukuphila lohlaselwayo azikwazi ukulondolozwa yokuvimbela kuphela compounds organophosphorus, futhi isheshe kwethulwa, iyoba sethubeni elihle lokuba isisulu kuyoba umphumela omuhle lesi sifo.

Ukwahlukaniswa sinqobe

Sinqobe zihlukaniswa ngamaqembu amane:

• lingaze (kwemithi);
• kwamakhemikhali (toxicokinetic);
• chemical (toksikotropnye);
• antitoxic Immunopreparat.

Lapho izimpawu zokuqala ubuthi organophosphate, okwamanje isinyathelo dogospitalizatsii isisulu, futhi isicelo ikhambi amaqembu toksikotropnoy lingaze, ngoba kubonisa ngokucacile ukusetshenziswa. Amalungiselelo isinyathelo toxicokinetic kudinga ukunamathela ngokuqinile imiyalelo, ngoba odokotela ambulensi abanakwethenjwa ngaso sonke isikhathi ukunquma ngokunembile izimpawu ukusetshenziswa yabo. Antitoxic Immunopreparat esetshenziswa ngendlela isikhungo sezokwelapha.

yokwelapha Ahlala Kuyo ubuthi acute ngu organophosphorus compounds

ngezenzakalo eziyinkimbinkimbi yakhiwa usebenzisa anticholinergics (atropine uhlobo imithi) lihambisana reactivator cholinesterase. Ngo phakathi nehora lokuqala ngemva esibhedlela olwenziwa atropine olunzulu. Atropine ngemithamo ezinkulu iqondiswa ngemithambo yegazi kwaba ukukhululeka izimpawu hyperhidrosis etholakalayo. Kufanele futhi kube izimpawu ababuthakathaka izidakamizwa ukweqisa izidakamizwa, uzwakalise isikhumba esomile kanye tachycardia ngokulinganisela.

Ukuze silondoloze lokhu isimo atropine iqondiswa ngokuphindaphindiwe, kodwa ngemithamo amancane. atropinization abasekelayo kudala ukuvinjelwa ephikelelayo izinhlelo m-cholinoreactive ezilimele anti-izidakamizwa isinyathelo somzimba acetylcholine esikhathini adingekayo ukubhujiswa nokuqeda ubuthi.

Modern cholinesterase Reaktivatory bakwazi ukuba baqinise izinhlelo ngempumelelo cholinesterase kwabacindezelwe futhi iwukudambisa phosphorus compounds ahlukahlukene. Lapho efeza yokwelapha ethile ukugadwa umsebenzi njalo cholinesterase.