Bariumndi zosakaniza zake
Dzina lamankhwala muchi China: Barium
Dzina lachingerezi:Barium, Ba
Toxic mechanism: Bariumndi chitsulo chofewa, choyera chasiliva chonyezimira cha alkaline chapadziko lapansi chomwe chilipo m'chilengedwe mu mawonekedwe a barite oopsa (BaCO3) ndi barite (BaSO4). Mankhwala a barium amagwiritsidwa ntchito kwambiri muzoumba, mafakitale a galasi, kuzimitsa zitsulo, mankhwala osiyanitsa mankhwala, mankhwala ophera tizilombo, kupanga mankhwala opangira mankhwala, ndi zina zotero.barium oxide, barium hydroxide, barium stearate, etc.Barium zitsulopafupifupi sanali poizoni, ndipo kawopsedwe wa mankhwala barium amakhudzana ndi kusungunuka kwawo. Mankhwala osungunuka a barium ndi oopsa kwambiri, pamene barium carbonate, ngakhale kuti pafupifupi osasungunuka m'madzi, ndi poizoni chifukwa cha kusungunuka kwake mu hydrochloric acid kupanga barium chloride. Waukulu limagwirira wa barium ion poizoni ndi blockage wa kashiamu amadalira njira potaziyamu mu maselo ndi barium ayoni, kumabweretsa kuwonjezeka okhudza maselo ambiri potaziyamu ndi kuchepa extracellular potassium ndende, chifukwa hypokalemia; Akatswiri ena amakhulupirira kuti ayoni barium angayambitse arrhythmia ndi zizindikiro za m'mimba mwa kulimbikitsa mwachindunji myocardium ndi minofu yosalala. Kuyamwa kwa sungunukabariummankhwala omwe amapezeka m'matumbo a m'mimba ndi ofanana ndi calcium, omwe amawerengera pafupifupi 8% ya mlingo wonse wa kudya. Mafupa ndi mano ndiwo malo akuluakulu oyikapo, omwe amawerengera 90% ya kuchuluka kwa thupi lonse.Bariumkulowetsedwa m`kamwa makamaka excreted kudzera ndowe; Ambiri mwa barium omwe amasefedwa ndi impso amalowetsedwanso ndi minyewa yaimpso, ndikungowoneka pang'ono mkodzo. Kuchotsa theka la moyo wa barium ndi pafupifupi masiku 3-4. Pachimake barium poyizoni nthawi zambiri amayamba chifukwa cha kumeza barium mankhwala monga nayonso mphamvu ufa, mchere, alkali ufa, ufa, alum, etc. Pakhala pali malipoti barium poizoni chifukwa cha kumwa madzi zakhudzana ndi barium mankhwala. Occupational barium pawiri poizoni ndi osowa ndipo makamaka otengeka kudzera kupuma thirakiti kapena kuonongeka khungu ndi mucous nembanemba. Pakhala palinso malipoti a poizoni omwe amayamba chifukwa cha kukhudzana ndi barium stearate, nthawi zambiri amakhala ndi subacute kapena matenda osachiritsika komanso nthawi yobisika ya miyezi 1-10.
Kuchuluka kwa chithandizo
Mlingo wapoizoni wa anthu omwe amatenga barium chloride ndi pafupifupi 0.2-0.5g
Mlingo wakupha kwa akuluakulu ndi pafupifupi 0.8-1.0g
chipatala mawonetseredwe: 1. The makulitsidwe nthawi ya m`kamwa poyizoni zambiri 0.5-2 hours, ndipo amene amadya kwambiri akhoza kukhala poyizoni zizindikiro mkati 10 mphindi.
(1) Zizindikiro zoyambirira za m'mimba ndi zizindikiro zazikulu: kutentha kwa m'kamwa ndi mmero, kuuma kwa khosi, chizungulire, mutu, nseru, kusanza, kupweteka kwa m'mimba, kutsegula m'mimba kawirikawiri, chimbudzi chamadzi ndi magazi, limodzi ndi chifuwa cholimba, kugunda kwa mtima, ndi dzanzi. m’kamwa, kumaso, ndi m’miyendo.
(2) Kufa kwa minofu yapang'onopang'ono: Odwala amayamba kukhala ndi ziwalo zosakwanira komanso zowonongeka, zomwe zimachokera ku minofu yakutali kupita ku minofu ya khosi, minofu ya lilime, minofu ya diaphragm, ndi minofu yopuma. Kupuwala kwa minofu ya lilime kungayambitse vuto la kumeza, kusokonezeka kwa mawu, ndipo zikavuta kwambiri, kupuma kwa minofu ya kupuma kungayambitse kupuma movutikira ngakhalenso kukomoka. (3) Kuwonongeka kwa mtima: Chifukwa cha poizoni wa barium ku myocardium ndi zotsatira zake za hypokalemic, odwala amatha kuwonongeka kwa myocardial, arrhythmia, tachycardia, kawirikawiri kapena kangapo nthawi yayitali, diphthongs, triplets, atria fibrillation, conduction block, etc. Odwala kwambiri. amatha kukhala ndi arrhythmia yoopsa, monga ma ectopic rhythms, yachiwiri kapena yachitatu digiri ya atrioventricular block, ventricular flutter, ventricular fibrillation, komanso ngakhale kumangidwa kwa mtima. 2. The makulitsidwe nthawi ya inhalation poizoni nthawi zambiri zimasinthasintha pakati pa 0,5 kwa 4 hours, kusonyeza kupuma mkwiyo zizindikiro monga zilonda zapakhosi, youma pakhosi, chifuwa, kupuma movutikira, chifuwa chothina, etc., koma zizindikiro m`mimba ndi wofatsa, ndipo zizindikiro zina zachipatala ndizofanana ndi poyizoni wamkamwa. 3. Zizindikiro monga dzanzi, kutopa, nseru, ndi kusanza zimatha kuwoneka pasanathe ola la 1 mutatha kuyamwa khungu lapoizoni kudzera pakhungu lowonongeka ndi kutentha kwapakhungu. Odwala omwe amapsa kwambiri amatha kukhala ndi zizindikiro mwadzidzidzi mkati mwa maola 3-6, kuphatikizapo kukomoka, kupuma movutikira, komanso kuwonongeka kwakukulu kwa myocardial. The matenda mawonetseredwe ndi ofanananso m`kamwa poyizoni, ndi wofatsa m`mimba zizindikiro. Matendawa nthawi zambiri amawonongeka mofulumira, ndipo chidwi chachikulu chiyenera kuperekedwa kumayambiriro.
The diagnostic
mfundo zachokera mbiri ya kukhudzana ndi barium mankhwala mu kupuma thirakiti, m`mimba thirakiti, ndi khungu mucosa. Matenda mawonetseredwe monga flaccid minofu ziwalo ndi kuwonongeka m`mnyewa wamtima angayambe, ndi zasayansi mayesero angasonyeze refractory hypokalemia, amene angathe kuzindikiridwa. Hypokalemia ndi maziko a pathological a pachimake barium poizoni. Kuchepa kwamphamvu kwa minofu kuyenera kusiyanitsidwa ndi matenda monga hypokalemic periodic paralysis, poisoning botulinum poisoning, myasthenia gravis, progressive muscular dystrophy, peripheral neuropathy, and acute polyradiculitis; Zizindikiro za m'mimba monga nseru, kusanza, ndi kupweteka kwa m'mimba ziyenera kusiyanitsidwa ndi kupha chakudya; Hypokalemia ayenera kusiyanitsidwa ndi matenda monga trialkyltin poisoning, kagayidwe kachakudya alkalosis, banja periodic ziwalo, ndi primary aldosteronism; Arrhythmia iyenera kusiyanitsidwa ndi matenda monga poizoni wa digitalis ndi matenda a mtima wamoyo.
Mfundo ya chithandizo:
1. Kwa iwo omwe amakumana ndi khungu ndi mucous nembanemba kuti achotse zinthu zoopsa, malo okhudzana nawo ayenera kutsukidwa bwino ndi madzi oyera nthawi yomweyo kuti apewe kuyamwa kwina kwa ayoni a barium. Odwala akapsa ayenera kuthandizidwa ndi zilonda zamoto ndi kupatsidwa 2% mpaka 5% sodium sulfate pakutsuka bala; Amene amakoka mpweya kudzera m'mapapo ayenera kuchoka pamalo omwe ali ndi poizoni, kuchapa m'kamwa mwawo mobwerezabwereza kuti ayeretse m'kamwa, ndi kutenga sodium sulfate yokwanira pakamwa; Kwa iwo omwe amadya kudzera m'mimba, ayenera kusamba m'mimba ndi 2% mpaka 5% sodium sulfate solution kapena madzi, ndiyeno 20-30 g ya sodium sulfate yotsegula m'mimba. 2. Detoxification mankhwala sulphate akhoza kupanga insoluble barium sulphate ndi barium ayoni kuti detoxify. Chosankha choyamba ndikubaya 10-20ml ya 10% sodium sulfate kudzera m'mitsempha, kapena 500ml ya 5% sodium sulfate kudzera m'mitsempha. Kutengera momwe zilili, zitha kugwiritsidwanso ntchito. Ngati palibe sodium sulfate reserve, sodium thiosulfate ingagwiritsidwe ntchito. Pambuyo mapangidwe insoluble barium sulphate, izo excreted kudzera impso ndipo amafuna kumatheka madzimadzi m`malo ndi diuresis kuteteza impso. 3. Kuwongolera panthawi yake ya hypokalemia ndiyo chinsinsi chopulumutsira kwambiri mtima wa arrhythmia ndi kupuma kwa minofu ya kupuma chifukwa cha poizoni wa barium. Mfundo ya potaziyamu yowonjezera ndikupereka potaziyamu yokwanira mpaka electrocardiogram ibwerere mwakale. Poyizoni pang'ono akhoza zambiri kuperekedwa pakamwa, ndi 30-60ml wa 10% potaziyamu kolorayidi likupezeka tsiku lililonse mu mlingo wogawanika; Odwala ochepera mpaka owopsa amafunikira mtsempha wowonjezera wa potaziyamu. Odwala omwe ali ndi poizoni wamtunduwu nthawi zambiri amalekerera potaziyamu, ndipo 10-20ml ya 10% potaziyamu kolorayidi amatha kulowetsedwa ndi 500ml ya physiological saline kapena glucose solution. Odwala kwambiri amatha kuwonjezera kuchuluka kwa potaziyamu kolorayidi mtsempha mpaka 0.5% ~ 1.0%, ndipo kuchuluka kwa potaziyamu kumatha kufika 1.0 ~ 1.5g pa ola limodzi. Odwala ovuta nthawi zambiri amafunikira mankhwala osagwirizana ndi potaziyamu mofulumira pansi pa electrocardiographic monitoring. Okhwima electrocardiogram ndi magazi potaziyamu kuwunika ayenera kuchitidwa powonjezera potaziyamu, ndipo chidwi ayenera kulipira pokodza ndi aimpso ntchito. 4. Kuti athetse vuto la arrhythmia, mankhwala monga cardiolipin, bradycardia, verapamil, kapena lidocaine angagwiritsidwe ntchito pochiza malinga ndi mtundu wa arrhythmia. Kwa odwala omwe ali ndi mbiri yachipatala yosadziwika komanso kusintha kwa potaziyamu electrocardiogram, potaziyamu yamagazi iyenera kuyesedwa nthawi yomweyo. Kungowonjezera potaziyamu nthawi zambiri kumakhala kosathandiza ngati mulibe magnesium, ndipo chidwi chiyenera kulipidwa pakuwonjezera magnesium nthawi yomweyo. 5. Mawotchi mpweya mpweya kupuma minofu ziwalo ndi chifukwa chachikulu cha imfa mu barium poizoni. Pamene kupuma kwa minofu ya kupuma kumawonekera, endotracheal intubation ndi makina mpweya wabwino ayenera kuchitidwa mwamsanga, ndipo tracheotomy ingakhale yofunikira. 6. Kafukufuku akusonyeza kuti njira zoyeretsera magazi monga hemodialysis zimatha kufulumizitsa kuchotsedwa kwa ayoni a barium m'magazi ndikukhala ndi chithandizo chamankhwala. 7. Zizindikiro zina zothandizira odwala kusanza kwambiri ndi kutsekula m'mimba ziyenera kuwonjezeredwa mwamsanga ndi madzi kuti madzi ndi electrolyte azikhala bwino komanso kupewa matenda achiwiri.
Nthawi yotumiza: Sep-12-2024