Organophosphorus amagwiritsidwa ntchito: kugwiritsa ntchito, mfundo ndi zochita. Poizoni ndi organophosphorus mankhwala, thandizo loyamba

Mankhwala a Organophosphorus ndi a gulu la mankhwala ophera tizilombo omwe amayenera kuwonongedwa kwa namsongole, tizilombo ndi makoswe.

Tizilombo toyambitsa matendawa sitigwiritsidwa ntchito pokhapokha mu ulimi, komanso m'moyo wa tsiku ndi tsiku. Mitundu yambiri ya OPC imakhala ndi poizoni wambiri ndipo ikhoza kuyambitsa poizoni pokhapokha mutalowa m'thupi, ndikukumana ndi mazira a maso ndi maso, komanso ndi khungu lolimba.

Ziwerengero za poizoni za WCF

Kumwa mowa kwambiri ndi organophosphorous mankhwala ndi malo oyamba pakati pa zoopsa zowonongeka, osati molimbika, komanso mobwerezabwereza. Kupha kwa poizoni koteroko ndi pafupifupi 20%, ndipo nthawi zambiri - pafupifupi 15 peresenti ya zoledzeretsa zonse. N'zochititsa chidwi kuti mowa ndi mtundu wotsutsa poizoni ndi mankhwala a organophosphorus. Odwala omwe anali ndi vuto loledzeretsa mowa panthawi ya mankhwala ophera tizilombo, matendawa ndi ovuta kwambiri (kupweteka ndi paresis ya minofu ya kupuma sikupezeka). Komabe, matenda a chilengedwe amatha kutchulidwa kwambiri.

Zomwe zingayambitse tizilombo toyambitsa matenda

Kupha poizoni ndi organophosphorous mankhwala akhoza kugwirizanitsidwa ndi ntchito za ntchito ndipo zingatheke chifukwa cha kusatsatira malamulo okhudza poizoni. Kusanyalanyaza kwa munthu mmodzi kapena angapo kungasandulire poizoni okha, koma kumathandizanso kuledzeretsa.

Komanso , poizoni ndi organophosphorus mankhwala akhoza kukhala a chilengedwe. Zifukwa za ngozi zingakhale zosiyana, mwachitsanzo:

• Kusakhala ndi zizindikiro m'thumba ndi madzi owopsa omwe amasungidwa kunyumba (munthu akhoza kutenga poizoni mkati mwa kulakwitsa, kapena mwadala chifukwa chaledzera);
• Kusungirako tizilombo komwe malo amapezeka kwa ana (ana mwachibadwa ali ofunitsitsa kwambiri, ndipo ngakhale chidebe chokhala ndi mankhwala ophera tizilombo, mwana wamng'ono akhoza kumwa madzi oopsa ndi kupha poizoni);
• Kusagwirizana ndi malamulo oteteza chitetezo (kunyalanyaza zipangizo zotetezera pogwiritsa ntchito mankhwala owopsa m'nyumba, monga kupuma, magolovesi, mapiritsi, zovala zoteteza).

Pamene organophosphorus imagwidwa ndi mankhwala akuluakulu amalowa m'thupi la munthu, imatha kuwononga mbali zosiyanasiyana za mitsempha ya mitsempha, yomwe imayambitsa matenda a neuritis, kuuma ziwalo ndi zotsatira zina zoipa, ngakhale imfa.

Dongosolo la mankhwala a organophosphorous molingana ndi mlingo wa poizoni

• Mankhwala owopsa kwambiri omwe amachokera ku thiophos, metaphos, mercapto-phos, octamethyl;
• Zopweteka kwambiri - zokonzekera za methylmercaptophosphate, phosphamide, dichlorophosphate;
• Zophatikiza-poizoni - chlorophos, carbofos, methylnitrophos ndi tizilombo toyambitsa matenda zomwe zimadalira, komanso saiphos, cyanophos, tribufos;
• Dothi-poizoni - demopos, bromophos, temefos.

Zizindikiro za poizoni wa WCF

Mwa kuuma, poizoni amagawidwa mu magawo atatu. Kachipatala poizoni ndi mankhwala a organophosphorus ndi awa:

Ndikumwa mowa mopitirira muyeso (siteji I):

• Kusokonezeka maganizo ndi mantha;
• Kupuma pang'ono;
• Ana osokonezeka (miosis);
• Kumva kupweteka m'mimba;
• Kuchulukitsitsa ndi kusanza;
• Mutu wamphamvu;
• Kuthamanga kwa magazi;
• Kutuluka thukuta kwambiri;
• Kuthamanga kwa mpweya.

Pamene mawonekedwewa ndi ofanana (gawo 2):

• Kusokonezeka kwa maganizo kungapitirire kapena pang'onopang'ono m'malo mwa kulepheretsa, ndipo nthawi zina - ndi chiwonongeko;
• Akulankhulidwa kuti miosis, ophunzira athe kuleka kusiya;
• Zizindikiro zazikulu za hyperhidrosis zimawonetseredwa (salivation (salivation), thukuta, bronchorea (sputum excretion kuchokera ku bronchi) ikuwonjezeka);
• Fibrillar kugwedeza kwa maso, minofu pachifuwa, miyendo, ndi nthawi zina minofu yonse;
• Maonekedwe a periodic a hypertone wamba wa minofu ya thupi, tonic convulsions;
• Kuwonjezera mphamvu ya chifuwa;
• Kuponderezedwa kwa magazi kukufika pamtundu wapatali (250/160);
• Kusamalidwa mwadzidzidzi ndi kukodza, limodzi ndi zowawa zopweteka (zabodza).

Mtundu woopsa wa poizoni (siteji III):

• Wodwala amagwera pansi;
• Maganizo onse amafooka kapena alibe;
• Hypoxia woopsa;
• Chiwonongeko;
• Kusungidwa kwa zizindikiro za hyperhidrosis;
• Kusintha kwa minofu ya hypertonicity, myofibrillation, ndi tonic convulsions ndi kupunduka minofu kumasuka;
• Kupuma kumakhala koletsedwa kwambiri, kuchuluka kwafupipafupi kwa kayendetsedwe ka kupuma sikungokhala bwino, kufooka kwa malo opuma ndi kotheka;
• Kuthamanga kwa mtima kumachepetsedwa ku mfundo zofunika (40-20 pa min.);
• Tachycardia imakula (kupitirira 120 kugunda pa mphindi imodzi);
• Kupsyinjika kwa magazi kukupitirirabe;
• Amayambitsa matenda osokoneza bongo ndi edema komanso matenda ochulukirapo ambiri omwe amayamba kusokonezeka chifukwa cha kufooka kwa minofu ndi kupweteka kwa malo opuma;
• Khungu limaphimba kutembenuka, tsamba la cyanosis limatuluka (khungu ndi nthendayi zimakhala ndi magetsi).

Zotsatira za poyizoni ndi phosphorus zokhudzana ndi tizilombo toyambitsa matenda

Pamene organophosphorous mankhwala alowa mu thupi, thandizo loyamba loperekedwa mnthawi yake ndi lolondola ndi chimodzi mwa zifukwa zazikulu zomwe zimayambitsa njira yowonjezera ya matendawa. Kuzindikira kwa FOS kuledzera n'kosavuta kupanga molingana ndi chithunzi cha chithunzi, koma ngati zotsatira zake zidzakhala zabwino kapena wozunzika adzafa makamaka malingana ndi zomwe adokotala amachita.

Chifukwa cha poizoni wapamwamba, mankhwala a organophosphorous, akaledzera, amachititsa kuti zisamakhale zovuta kuwonongeka kwa ziwalo zonse zofunika ndi machitidwe. Pankhani imeneyi, ngakhale ndi zotsatira zabwino, ntchito za ziwalo zina sizingathetsedwe.

Zina mwa zovutazo, zomwe kawirikawiri zikutsatiridwa ndi kuledzera kwambiri ndi organophosphorous substances, zikuphatikizapo chibayo, nyimbo ndi kuchititsa mtima, kuledzeretsa maganizo, ndi zina zotero.

Chifukwa cha matendawa

M'masiku ochepa oyamba pambuyo poizoni wodwalayo ali ndi vuto lalikulu chifukwa cha kugwa kwa mtima. Kenaka amadzabwezera pang'onopang'ono komanso kukhala ndi moyo wabwino. Komabe, patadutsa masabata awiri, kukula kwa mankhwala oopsa a poizoni sikunatchulidwe. Nthaŵi zina, mitsempha yambiri ingagwire ntchitoyi.

Maphunziro a polyneuropathies oterewa amakhala otha msinkhu, nthawi zina amatsagana ndi mavuto osokoneza magalimoto. Kubwezeretsa kwa ntchito za pulogalamu yamanjenje yoipa ndizoipa. Pakhoza kukhalanso kubwerera kwa mavuto aakulu, monga mavuto aakulu. Izi zikufotokozedwa ndi mfundo yakuti gulu la organophosphorus "limatulutsidwa" kuchokera kumatenda osiyanasiyana kupita ku kayendetsedwe kake.

Chithandizo

Pamene poizoni ndi organophosphorous mankhwala akupezeka, thandizo loyamba liyenera kuphatikizapo kuyeretsa koopsa kwa kapangidwe ka m'mimba mwa kutsuka m'mimba ndi kafukufuku, kukakamiza kutsekemera, ndi zina zotero, kupitiriza kupuma komanso kugwiritsa ntchito mankhwala osokoneza bongo. Kenaka, njira yotsitsimutsira, kuphatikizapo pharmacotherapy, imagwiritsidwa ntchito kusunga ndi kubwezeretsa ntchito zowonongeka, kuphatikizapo njira zowonzetsera ntchito ya mtima, kuchiza matenda a homeostatic ndi exotoxic shock.

Kubwezeretsa ntchito ya kupuma

Organophosphorus amadziwika kuti kulowa mthupi mochulukira nthawi zambiri kumayambitsa kupuma, zomwe zimayambitsa matenda ochulukitsa oropharyngeal, bronchospasm ndi kufooka kwa mimba ya kupuma. Pachifukwa ichi, chinthu choyamba chimene madokotala akuyesera kuchita ndi kubwezeretsa kayendetsedwe ka ndege ndi kupereka mpweya wabwino. Pamaso mwa zizindikiro zambiri zowonongeka ndi kutaya kwa oropharyngeal, aspiration imagwiritsidwa ntchito (kumwa madzi ndi chithandizo chochotsera). Mu poizoni woopsa FOS reanimation miyeso imaphatikizapo mpweya wa trachea, mpweya wabwino.

Kuletsa mankhwala

Kugwiritsira ntchito zotsutsana (zoletsedwa) ndi mbali yofunikira ya pharmacotherapy yofulumira poizoni. Kukonzekera kwa gululi kumakhudza kinetics ya mankhwala owopsa m'thupi, kuonetsetsa kuti imatha kuyamwa kapena kuchotseratu, kuchepetsa zotsatira za poizoni pa mapulogalamu obisala, kuteteza kuopsa kwa metabolism ndi kuthetsa mavuto owopsa a ntchito zofunikira zomwe zimayambitsa poizoni.

Kuteteza kwa poizoni ndi mankhwala a organophosphorus kumatengedwa limodzi ndi mankhwala ena apadera. Pharmacotherapy ikuchitidwa chimodzimodzi ndi kubwezeretsedwa kwachidziwitso komanso njira zothandizira kuti mankhwala asokonezeke.

Tiyenera kukumbukira kuti ngati palibe kuthekera kofulumira kubwezeretsa, ndiye kuti moyo wa wogwidwawo ukhoza kupulumutsa mankhwala okhaokha a organophosphorous, ndipo poyambirira amayamba kufotokozedwa, mwinamwake wozunzidwayo amakhala ndi zotsatira zabwino za matendawa.

Chizindikiro cha zotsutsa

Zotsutsa zimagawidwa m'magulu anayi:

• Chizindikiro (pharmacological);
• Zachilengedwe (toxicokinetic);
• Mankhwala (toxicotropic);
• Antitoxic immunopreparations.

Ndi maonekedwe a zizindikiro zoyamba za poizoni ndi mankhwala a organophosphorus, ngakhale pa siteji ya pre-hospitalization ya wogwidwa, magulu otsutsa a magulu a zizindikiro ndi zoopsa, chifukwa ali ndi zizindikiro zomveka zogwiritsiridwa ntchito. Mankhwala osokoneza bongo amafunikira kutsatira mosamala malangizo, chifukwa madokotala a ambulensi sangathe kudziwa nthawi zonse zomwe angagwiritse ntchito. Mankhwala otchedwa Antitoxic immunopreparations amagwiritsidwa ntchito pazifukwa za chipatala.

Thandizo lapadera la poizoni woopsa ndi organophosphorus mankhwala

Zambirizi zimaphatikizapo kugwiritsa ntchito anticholinergics (mankhwala monga atropine) kuphatikizapo reagents. Mu ola loyamba mutatha kuchipatala kwa odwala kwambiri atropinization akuchitika. Atropine m'mayeso akulu amathandizidwa kuti asamayesetse zizindikiro za hyperhidrosis. Pamafunikanso kukhala ndi zizindikiro zowonjezereka kwa mankhwalawa, omwe amasonyeza ndi khungu louma komanso tachycardia.

Pofuna kukhalabe ndi vutoli, atropine imayendetsedwa mobwerezabwereza, koma m'mayeso ang'onoang'ono. Kutsekemera kwapadera kumachititsa kupitirizabe kutsekedwa kachitidwe ka m-cholinergic ya thupi lovulazidwa motsutsa ntchito ya acetylcholine kukonzekera nthawi yoyenera kuti chiwonongeko ndi kuthetsedwa kwa poizoni.

Reactivators zamakono zamakono zimatha kuyambitsa makina oponderezedwa oponderezedwa ndi kupopera mankhwala osiyanasiyana a phosphorous. Pochita chithandizo chokhazikika, ntchito yochepetsedwa ikuyang'aniridwa nthawi zonse.