Bariumnemisanganiswa yayo
Zita remushonga muchiChinese: Barium
Zita rechirungu:Barium, Ba
Toxic mechanism: Bariumisimbi yakapfava, yesirivha chena inopenya alkaline yepasi iripo muchimiro chechepfu barite (BaCO3) uye barite (BaSO4). Barium compounds inoshandiswa zvakanyanya mu ceramics, girazi indasitiri, simbi inodzima, mishonga yakasiyana-siyana yemishonga, mishonga yekuuraya zvipembenene, kugadzirwa kwemakemikari reagent, etc. Kazhinji barium compounds zvinosanganisira barium chloride, barium carbonate, barium acetate, barium nitrate, barium sulfate, barium sulfide,barium oxide, barium hydroxide, barium stearate, nezvimwewo.Barium simbiinenge isiri-chepfu, uye chepfu ye barium compounds inoenderana nekunyungudika kwayo. Soluble barium compounds ine muchetura zvakanyanya, nepo barium carbonate, kunyangwe isinganyunguke mumvura, ine chepfu nekuda kwekunyungudika kwayo muhydrochloric acid kuita barium chloride. Iyo huru nzira ye barium ion poisoning ndeyekuvhara kwe calcium inoenderana ne potassium migero mumasero ne barium ions, izvo zvinotungamirira kukuwedzera kwe intracellular potassium uye kuderera kwe extracellular potassium concentration, zvichiita kuti hypokalemia; Dzimwe nyanzvi dzinotenda kuti barium ions inogona kukonzera arrhythmia uye zviratidzo zvemudumbu nekukurudzira zvakananga myocardium uye mhasuru dzakatsetseka. Kutorwa kwe solublebariummacompounds ari mugumbo remudumbu akafanana neaya ecalcium, anoverengera angangoita 8% yehuwandu hwekunwa. Mabhonzo nemazino ndiwo makuru ekuisa nzvimbo, anoverengera pamusoro pe90% yehuwandu hwemuviri mutoro.Bariumkumwiwa nemuromo kunonyanya kubuda netsvina; Yakawanda yebhariyamu yakasefa neitsvo inodzoserwa nerenal tubules, iine chidimbu chidiki chinoonekwa muweti. Kubviswa kwehafu yehupenyu hwebarium inenge mazuva 3-4. Acute barium poisoning inowanzokonzerwa nekudya kwe barium compounds sehupfu hwekuvirisa, munyu, upfu hwealkali, upfu, alum, nezvimwewo. Pakave zvakare nemishumo yehutu hwebarium hunokonzerwa nekunwa mvura yakasvibiswa ne barium compounds. Occupational barium compound poisoning haiwanzoitika uye inonyanya kutorwa kuburikidza nekufema turakiti kana ganda rakakuvadzwa uye mucous membranes. Pakave zvakare nemishumo yehupfu hunokonzerwa nekusangana nebarium stearate, kazhinji ine subacute kana kusingaperi kutanga uye nguva yakanyarara yemwedzi 1-10.
Kurapa kwehuwandu
Iyo ine chepfu yehuwandu hwevanhu vanotora barium chloride inenge 0.2-0.5g
Mushonga unouraya wevakuru unosvika 0.8-1.0g
Kuratidzwa kwemakiriniki: 1. Nguva yekudzivirira yehupfu hwemuromo inowanzoita maawa 0.5-2, uye avo vane kudya kwakanyanya vanogona kuwana zviratidzo zvehupfu mukati memaminitsi gumi.
1 mumuromo, kumeso, nemakumbo.
(2) Progressive muscle paralysis: Varwere vanotanga vauya nemakumbo asina kukwana uye asina kukwana, iyo inofambira mberi kubva kumasumbu emakumbo kusvika kune mitsipa yemutsipa, mhasuru dzendimi, diaphragm tsandanyama, uye mhasuru dzekufema. Kuoma mitezo yetsandanyama yerurimi kunogona kukonzera kuoma kwekumedza, kusarongeka kwekutaura, uye muzviitiko zvakakomba, kupera simba kwetsandanyama yekufema kunogona kukonzera kutadza kufema uye kunyange kudzipwa. (3) Kukuvadzwa kwemwoyo: Pamusana pehutu hwe barium kune myocardium nemigumisiro yayo ye hypokalemic, varwere vanogona kukuvadzwa kwemyocardial, arrhythmia, tachycardia, kazhinji kana nguva yakawanda isati yasvika, diphthongs, triplets, atrial fibrillation, conduction block, nezvimwewo. inogona kunge iine arrhythmia yakaoma, yakadai seye ectopic rhythms yakasiyana, yechipiri kana yechitatu dhigirii atrioventricular block, ventricular flutter, ventricular fibrillation, uye kunyange kusungwa kwemwoyo. 2. The incubation period of inhalation poisoning inowanzochinja pakati pe0.5 to 4 hours, inoratidzwa sezviratidzo zvekushatirwa kwekufema zvakadai sekurwadziwa kwehuro, pahuro yakaoma, kukosora, kutadza kufema, kuoma kwechipfuva, zvichingodaro, asi zviratidzo zvekugaya zvinenge zvakapfava, uye zvimwe zviratidzo zvekiriniki zvakafanana nehupfu hwemuromo. . Varwere vakatsva zvakanyanya vanogona kungoerekana vaita zviratidzo mukati memaawa matatu-6, kusanganisira kugwinha, kunetseka kufema, uye kukuvara kukuru kwemyocardial. Kuratidzwa kwekiriniki kwakafananawo nehupfu hwemukanwa, ine zviratidzo zvinyoro zvemudumbu. Mamiriro acho anowanzoipa nekukurumidza, uye kutarisisa kwakanyanya kunofanirwa kubhadharwa mumatanho ekutanga.
The diagnostic
maitiro anoenderana nenhoroondo yekusangana ne barium makomisheni mukufema turakiti, digestive turakiti, uye ganda mucosa. Kuratidzira kwekiriniki kwakadai seflaccid tsandanyama kupera simba uye kukuvara kwemyocardial kunogona kuitika, uye bvunzo dzerabhoritari dzinogona kuratidza refractory hypokalemia, inogona kuongororwa. Hypokalemia ndiyo pathological hwaro hweacute barium chepfu. Kuderera kwesimba retsandanyama kunofanira kusiyaniswa nezvirwere zvakadai se hypokalemic periodic paralysis, botulinum toxin poisoning, myasthenia gravis, progressive muscular dystrophy, peripheral neuropathy, uye acute polyradiculitis; Zviratidzo zvemudumbu zvakadai sekusvotwa, kurutsa, uye mazamu emudumbu anofanira kusiyaniswa kubva kune chepfu yezvokudya; Hypokalemia inofanira kusiyaniswa kubva kune zvirwere zvakadai se trialkyltin poisoning, metabolic alkalosis, mhuri periodic paralysis, uye primary aldosteronism; Arrhythmia inofanira kusiyaniswa kubva kune zvirwere zvakadai se digitalis poisoning uye organic heart disease.
Nheyo yekurapa:
1. Kune avo vanosangana neganda uye mucous membranes kuti vabvise zvinhu zvine chepfu, nzvimbo yekubatana inofanira kushambidzwa zvakakwana nemvura yakachena pakarepo kudzivirira kuwedzera kutorwa kwebarium ions. Varwere vakatsva vanofanira kurapwa nekupiswa kwemakemikari uye kupiwa 2% kusvika 5% sodium sulfate yemunharaunda yekutsvaira kweronda; Avo vanofema nemukati mekufema vanofanira kubva ipapo kubva panzvimbo ine chepfu, vogeza muromo wavo kakawanda kuti vachenese muromo wavo, uye kutora yakafanira sodium sulfate nemuromo; Kune avo vanopinda nemudumbu, vanofanira kutanga vageza dumbu ravo ne2% kusvika 5% yesodium sulfate solution kana mvura, vozoisa 20-30 g yesodium sulfate pakuita manyoka. 2. Detoxification drug sulfate inogona kugadzira insoluble barium sulfate ine barium ions kuti ibvise huturu. Sarudzo yekutanga ndeyekubaya 10-20ml ye10% sodium sulfate intravenously, kana 500ml ye5% sodium sulfate intravenously. Zvichienderana nemamiriro ezvinhu, inogona kushandiswa zvakare. Kana pasina sodium sulfate reserve, sodium thiosulfate inogona kushandiswa. Mushure mekugadzirwa kweinsoluble barium sulfate, inobudiswa kuburikidza neitsvo uye inoda kuwedzerwa kushandiswa kwemvura uye diuresis kuchengetedza itsvo. 3. Kugadziriswa panguva yakakodzera ye hypokalemia ndiyo kiyi yekununura yakanyanya cardiac arrhythmia uye kufema kwemhasuru kuonda kunokonzerwa ne barium poisoning. Nheyo ye potassium supplementation ndeyokupa potassium yakakwana kusvikira electrocardiogram yadzokera kune yakajairika. Chepfu yakapfava inogona kazhinji kupihwa nemuromo, ine 30-60ml ye10% potassium chloride inowanikwa zuva nezuva muzvikamu zvakakamurwa; Varwere vane mwero kusvika kune vakakomba vanoda intravenous potassium supplementation. Varwere vane chepfu yerudzi urwu vanowanzove nekushivirira kwe potassium, uye 10 ~ 20ml ye10% potassium chloride inogona kuiswa mutsinga ne500ml ye physiological saline kana glucose solution. Varwere vakaoma vanogona kuwedzera kuwedzera kwe potassium chloride intravenous infusion kusvika 0.5% ~ 1.0%, uye potassium supplementation rate inogona kusvika 1.0 ~ 1.5g paawa. Varwere vanorwara vanowanzoda maitiro asina kujairika uye nekukurumidza potassium supplementation pasi pe electrocardiographic monitoring. Yakasimba electrocardiogram uye ropa potassium monitoring inofanira kuitwa pakuwedzera potassium, uye kutarisisa kunofanira kubhadharwa weti uye renal basa. 4. Kuti udzore arrhythmia, zvinodhaka zvakadai se cardiolipin, bradycardia, verapamil, kana lidocaine zvinogona kushandiswa pakurapa maererano nemhando ye arrhythmia. Kune varwere vane nhoroondo yekurapa isingazivikanwe uye yakaderera potassium electrocardiogram shanduko, potassium yeropa inofanira kuongororwa nekukurumidza. Kungowedzera potassium kazhinji hakushandi kana usina magnesium, uye pfungwa dzinofanira kubhadharwa pakuwedzera magnesium panguva imwe chete. 5. Mechanical ventilation breathing muscle paralysis ndicho chikonzero chikuru chekufa mu barium poisoning. Kamwe kufema kwetsandanyama mitezo kunoonekwa, endotracheal intubation uye mechanical ventilation inofanira kuitwa pakarepo, uye tracheotomy inogona kudiwa. 6. Tsvakurudzo inoratidza kuti matanho ekuchenesa ropa akadai sehemodialysis anogona kukurumidza kubviswa kweiyo barium kubva muropa uye ane humwe hutano hwehutano. 7. Zvimwe zviratidzo zvinotsigira kurapwa kwekurutsa kwakanyanya uye varwere vane manyoka vanofanira kukurumidza kuwedzerwa nemvura kuchengetedza mvura uye electrolyte kuenzana uye kudzivirira zvirwere zvechipiri.
Nguva yekutumira: Sep-12-2024