Organophosphates: ngwa, nzọụkwụ na atụmatụ edumbet. Organophosphate nsi, mbụ enyemaka

Organophosphates bụ ọgwụ na edemede, nke na-e-egbu ata, ụmụ ahụhụ na òké.

Ndị a ụmụ ahụhụ na-n'ọtụtụ ebe ọ bụghị nanị na agriculture kamakwa ná ndụ kwa ụbọchị. Ọtụtụ iche FOS dị nsị dị elu na ike na-eme ka oké njọ nsi site ingestion nke ma n'ime ahu na na kọntaktị na gọzie gị mucosa na anya, na ọbụna na-emebibeghị anụ.

Statistics FOS nsi

Nnukwu igbu egbu site organophosphorus ogige n'ezie ewe mbụ n'etiti ndị ọzọ exogenous nsi bụghị naanị ike ndọda ma site ugboro. Lethality dị nsi fọrọ nke nta ka 20%, mgbe ugboro nke - banyere 15% nke ihe nile ikpe nke igbu egbu. Of mmasị bụ eziokwu na peculiar ngwọta maka organophosphate nsi bụ mmanya. Na ọrịa nọ na a ala nke oké igbu egbu n'oge nsi na ụmụ ahụhụ, ọrịa bụ nnọọ mfe (ụfụ na paresis nke akụkụ okuku ume na uru adịghị). Otú ọ dị, hemodynamic ọrịa nwere ike ịbụ ihe ọzọ akpọ.

Ekwe Omume akpata nsi na ụmụ ahụhụ

Organophosphate nsi nwere ike ịbụ n'ihi ọrụ na ime n'ihi na-ezighị ezi njikwa of bekee. Ileghara nke otu ma ọ bụ karịa mmadụ nwere ike ịkpata bụghị naanị a oké njọ nsi maka onwe ha, ma na-eduga uka igbu egbu.

Ke adianade a, nsi site organophosphorus ogige ga-eyi kwa ụbọchị okike. Na-akpata ihe mberede nwere ike dị iche iche, n'ihi na ihe atụ:

• dịghị ihe ịrịba ama na containers na mmiri nsị, echekwara n'ụlọ (onye nwere ike na-nsi n'ime n'amaghị ma ọ bụ kpachapụrụ n'ihi nzube nke igbu egbu);
• nchekwa nke ụmụ ahụhụ na-apụghị iru nke ụmụaka (ụmụ site na okike dị nnọọ ọchịchọ ịmata, na ọbụna ma ọ bụrụ na a akpa of Chemicals ga-aka, a obere nwa ka nwere ike na-aṅụ a ize ndụ na mmiri mmiri na-esi na nnukwu nsi);
• ọdịda ime na nchekwa ụkpụrụ (nleghara anya pụtara nke nchebe mgbe eji na ezinụlọ nsi, dị ka ájá nkpuchi, uwe, enyoanya, na-echebe uwe).

Mgbe organophosphorus compound na nnukwu doses ada n'ime ahụ mmadụ, ha nwere ike ime ka ọnya nke akụkụ dị iche iche nke Central ụjọ usoro nke na-eduga neuritis, mkpọnwụ na ndị ọzọ na akwa ya pụta, gụnyere ọnwụ.

Nhazi ọkwa nke organophosphorus ogige na toxicity

• ndị kasị nwee nsí - dabeere ụmụ ahụhụ thiophos, Metaphos, merkaptofosa, octamethyl;
• na-egbu egbu - ọgwụ ọjọọ eme ihe dabere na demeton-s-methyl, phosphamide, dichlorophosphate;
• srednetoksichnye - trichlorfon, malathion, metilnitrofos na ụmụ ahụhụ dabeere na ha, nakwa dị ka sayfos, cyanophos, tribufos;
• ala-toxicity - demufos, bromophos, temephos.

Mgbaàmà nke nsí FOS

Dị ka ogo nsi nke ike ndọda na-ekewa n'ime 3 nkebi. Clinic organophosphate nsi bụ dị ka ndị:

Nwayọọ mmenaanya (m ogbo):

• psychomotor n'ahụhụ na mmetụta nke egwu;
• iku ume ọkụ ọkụ;
• dilated ụmụ akwụkwọ (miosis);
• spastic mgbu n'afọ;
• ụba salivation na vomiting;
• oké isi ọwụwa;
• ọbara mgbali elu;
• profuse sweating;
• wheezing.

Na agafeghị oke ụdị (II ogbo):

• n'ahụhụ nwere ike nọgidere na-enwe ma ọ bụ nwayọọ nwayọọ na-anọchi mgbochi, na mgbe ụfọdụ - na amaghị onwe;
• Omume miosis, ka nwa ìhè ghara ikwu;
• maximally gosi mgbaàmà nke hyperhidrosis (maximized salivation (asu), sweating, bronhoreya (phlegm si bronchi));
• fibrillar twitching eyelids, mọzụlụ nke obi, ụkwụ, na mgbe ụfọdụ niile nke uru ahụ;
• oge n'ile hyper ngụkọta ahu mọzụlụ, tonic ụfụ;
• dị ịrịba ama enwekwu ụda olu nke obi;
• ọbara mgbali esịmde a kacha arụmọrụ (250/160);
• ịsụ defecation na urination, Bilie mgbu tenesmus (ụgha ọchịchọ).

Siri ike nsi (III ogbo):

• onye ọrịa adaghị a miri emi amaghị onwe ya;
• All na-aghọ nkọ na-ebelata ma ọ bụ kpam kpam na-anọghị;
• oké hypoxia;
• akpọ miosis;
• ichebe hyperhidrosis mgbaàmà;
• mgbanwe nke muscular hypertonus, miofibrillyatsii na tonic ụfụ kpọnwụrụ akpọnwụ muscle ntụrụndụ;
• ike mbà n'obi respiration omimi na ugboro ole nke ume nke na-oge ufodu, o kwere omume akụkụ okuku ume na mkpọnwụ;
• obi ọnụego na-lowered ka oké egwu na-egosi (40-20 min.);
• tachycardia enwekwukwa (ihe karịrị 120 gafere kwa min.);
• ọbara mgbali na-aga n'ihu na-ada;
• emepe emepe na-egbu egbu encephalopathy na edema na hemorrhages ọtụtụ diapedetic ọkacha mma mbuaha ụdị, n'ihi na mkpọnwụ nke akụkụ okuku ume uru na mgbochi nke akụkụ okuku ume center;
• akpụkpọ inikiet inikiet agwụ egosi cyanosis (akpụkpọ mucous membranes ibu bluish agba).

Ndị na-esi nsi site ụmụ ahụhụ

Mgbe ahụ na-ada organophosphorus ogige, mbụ enyemaka sụgharịrị n'egbughị oge na n'ụzọ kwesịrị ekwesị, bụ otu n'ime isi ihe na-ekpebi n'ihu N'ezie nke ọrịa. FOS mmenaanya nchoputa bụ dịtụ mfe na-etinye na e ji mara na-adakarị picture Otú ọ dị, ma pụta nke mma ma ọ bụ na-aja nwụrụ, na-adabere n'ụzọ dị ukwuu na ndị na-elu ọgwụ na ahụ ike.

Ruru akwa toxicity nke organophosphorus ogige mgbe ingested eme irreparable nsogbu fọrọ nke nta niile dị oké mkpa akụkụ na usoro. Banyere nke a, ọbụna a mma pụta ka n'ụzọ zuru ezu weghachi ọrụ nke ụfọdụ akụkụ na-gwụsịrị.

N'etiti nsogbu, nke a na-emekarị so site oké igbu egbu site organophosphorus ogige gụnyere oyi baa, gbasara obi arrhythmias na gbasara obi conduction, umi na-akpata psychosis na nnukwu ụdị, wdg

ọrịa

N'oge mbụ ụbọchị ole na ole mgbe ndị nsi, onye ọrịa bụ na a oké njọ ọnọdụ mere site obi ida. Mgbe ahụ na-abịa a jiri nwayọọ nwayọọ na-akwụ ụgwọ na mma ahụ ike. Otú ọ dị, mgbe 2-3 izu, ọ bụ omume na mmepe nke oké na-egbu egbu polyneuropathy. Mgbe ụfọdụ, na usoro nwere ike aka a ọnụ ọgụgụ nke cranial irighiri akwara.

N'oge ndị a gasịrị polyneuropathy zuru ezu ruo ogologo oge, mgbe ụfọdụ, esonyere persistent ije ọrịa. Weghachi ọrụ nke elu ụjọ usoro ọjọọ. O nwekwara ike ime nloghachi nke nnukwu ọrịa, dị ka cholinergic nsogbu. Ihe kpatara ya bụ na-edebe organophosphorus compound "ejected" si dị iche iche anụ ahụ n'ime ọbara usoro.

ọgwụgwọ

Mgbe ikpe nke oké njọ nsi site organophosphorus ogige, mbụ enyemaka kwesịrị ịgụnye ike ike ihicha nke digestive tract site gastric lavage eji a nyocha amanye diuresis, wdg, mmezi nke respiration na ojiji nke kpọmkwem mgbochi. Ọzọkwa, a mgbagwoju nke iji tụtee mmadụ, gụnyere pharmacotherapy, iji na ịnọgide na-enwe na Iweghachi mebiri emebi ahu aru, tinyere jikoro iji weghachi gbasara obi ọrụ, ọgwụgwọ nke ọrịa nke homeostasis na exotoxic ujo.

Mweghachi nke akụkụ okuku ume na ọrụ

Organophosphorus ogige tọrọ atọ na ahụ na nnukwu quantities, na-emekarị-eme ka akụkụ okuku ume na nsogbu, kpatara oké oropharyngeal secretion, na bronchoconstriction mkpọnwụ nke akụkụ okuku ume na akwara. Na njikọ na nke a, ihe mbụ na ndị dọkịta na-agbalị ime - bụ iji weghachi airway ma hụ ezigbo ventilashion. Na ọnụnọ nke ukwuu vomitus na oropharyngeal agbapụta n'ahụ, na-emetụta ọchịchọ (oriri nke dị mmiri mmiri site agụụ). Na nnukwu nsi FOS iji tụtee mmadụ na-agụnye endotracheal intubation, n'ibu ventilashion.

ngwọta ọgwụ

Ngwa safeners (mgbochi) bụ akụkụ dị mkpa nke mberede pharmacotherapy na nnukwu nsi. Drugs na otu a emetụta kinetics dị na aru nke nsi, na-enye ya absorption ma ọ bụ iwepụ, ala mmetụta nsí anabata gbochie ize ndụ metabolize na iwepụ ize ndụ ọrịa dị oké mkpa ahu aru, mere site igbu egbu.

Ngwọta maka nsi site organophosphorus ogige e ọnụ na ndị ọzọ pụrụ iche na ọgwụ ọjọọ. Pharmacotherapy ẹkenịmde ke ukem na n'ozuzu iji tụtee mmadụ na detoxifying ọgwụgwọ jikoro.

Ọ ga-echeta na ọ dịghị ekwe omume nke ozugbo iji tụtee mmadụ, na aja ndụ a pụrụ ịzọpụta naanị ngwọta organophosphorus ogige, na mee elu mee ya na ẹkenam, mma ohere na aja ga-a mma pụta nke ọrịa.

nhazi ọkwa nke mgbochi

Mgbochi na-nkewa n'ime anọ dị iche iche:

• symptomatic (pharmacological);
• Biochemical (toxicokinetic);
• chemical (toksikotropnye);
• antitoxic Immunopreparat.

Mgbe mbụ mgbaàmà nke organophosphate nsi, ma ụkwụ na ụkwụ dogospitalizatsii aja, ma na-etinye ọgwụ symptomatic toksikotropnoy iche iche, ebe ọ bụ na ha nwere a doro anya na-egosi maka ojiji. Preparations toxicokinetic edinam achọ ịgbasochi ka ntụziaka, n'ihi na ụgbọ ihe mberede dọkịta nwere ike ọ bụghị mgbe niile n'ụzọ ziri ezi chọpụta na-egosi ka ha were. Antitoxic Immunopreparat eji na a ọgwụ alụmdi.

Specific ọgwụ na nnukwu nsi site organophosphorus ogige

Mgbagwoju ihe mejupụtara iji anticholinergics (atropine ụdị ọgwụ) na Nchikota na a cholinesterase reactivator. Ke akpa awa mgbe ụlọ ọgwụ ekenịmde kpụ ọkụ n'ọnụ atropine. Atropine na nnukwu doses na-ndinọ intravenously enyemaka nke mgbaàmà nke hyperhidrosis dị. Kwesịkwara ịrịba ama nke na-adịghị ike ọgwụ ovadozu, kwupụtara na akọrọ akpụkpọ na-agafeghị oke tachycardia.

Iji nọgide na steeti a nke atropine na-ndinọ ugboro ugboro, ma na obere na obere doses. Aka atropinization emepụta a persistent mgbochi nke m-cholinoreactive usoro mebiri emebi ahụ mgbochi ọgwụ edinam nke acetylcholine na oge a chọrọ maka mbibi na mkpochapu nsị.

Modern Reaktivatory cholinesterase ike n'ụzọ dị irè ike emegbu emegbu cholinesterase na neutralize dị iche iche site ogige. Na-arụ kpọmkwem ọgwụ a na-nyochaa mgbe niile cholinesterase ọrụ.