Organophosphates: kopo, mehato le likarolo molao-motheo. Organophosphate chefo, thuso ea pele

Organophosphates ke lik'hemik'hale dihlopha, tse etselitsoeng ho bolaea mofoka, likokoanyana le litoeba.

bolaeang likokoanyana tsena tse sebelisoang haholo, eseng feela ka temo empa hape le ka bophelo ba letsatsi le letsatsi. mefuta e sa tsoaneng tse ngata tsa FOS ke haholo nang le chefo e le ka etsa hore chefo e le tse tebileng ke a e-ja tsa ka hare 'mele' me a kopana le nasal mucosa le leihlo, 'me esita le ka letlalo senyeha.

Lipalo-palo li FOS chefo

Hlobaetsang botahoa ke metsoako organophosphorus ha e le hantle nka le sebaka sa pele har'a tse ling exogenous chefo matla a khoheli se feela empa hape ke maqhubu. Lethality chefo joalo ke hoo e ka bang 20%, ha maqhubu a ya - ka bang 15% ea linyeoe kaofela botahoa. Thahasella ke hantle hore pheko ea ikhethang ho chefo organophosphate ke joala. Ka bakuli ba ba ne ba le boemong ba ho botahoa feteletseng nakong ea chefo le bolaeang likokoanyana, lefu lena le bonolo haholo (tsitsipana le paresis tsa mesifa matšoafo ha fumaneha). Leha ho le joalo, maloetse a hemodynamic ka 'na ba ho feta bitsoa.

bakang khoneha ya chefo le bolaeang likokoanyana

Organophosphate chefo e ka ba ka lebaka la ho mosebetsing le hlaha ka lebaka la ho tshwara lokang ya dintho tse chefo. Ho se tsotelle ba batho le 'ngoe kapa ho feta ka' na fella ka se feela chefo e tebileng bakeng sa bona, empa hape lebisa boima botahoa.

Ho phaella ho sena, ho chefo ka metsoako organophosphorus ka tsofetseng tlhaho letsatsi le letsatsi. Lisosa tsa dikotsi ka ba fapaneng, ho etsa mohlala:

• ha ho na matšoao ka lik'hontheinara le mokelikeli chefo, bolokwa lapeng (motho a ka e nkang e chefo e ka hare ke phoso kapa ka boomo ka morero oa ho botahoa);
• polokelo ea bolaeang likokoanyana ka finyella bana (bana ba ka tlhaho ke labalabela ho tseba haholo, 'me le haeba e le setshelo ya lik'hemik'hale tse chefo tla saennoe, ngoana e monyenyane a ka ntse noa mokelikeli kotsi le fumana a hlobaetsang le chefo);
• ho hlōleha ho etsa lintho tumellanong le melao ea tsamaiso polokeho (ho hlokomolohuoa ho bolela ea tsireletso ea hae ha sebelisoa ka tlung ea chefo, tse kang leru la lerole maske, litlelafo, goggles, liaparo le sireletsang).

Ha organophosphorus komponeng ka tekanyetso kgolo a oa ka hare ho 'mele oa motho, ba ile ba ka etsa hore diso tsa likarolo tse sa tšoaneng tsa tsamaiso ea bohareng tšohile hore e isang neuritis, shoele litho le liphello tse ling tse tebileng, ho akarelletsa le lefu.

Classification tsa metsoako organophosphorus ka toxicity le

• ka ho fetisisa nang le chefo - thehiloeng bolaeang likokoanyana thiophos, Metaphos, merkaptofosa, octamethyl;
• chefo - lithethefatsi thehiloeng ho demeton-s-methylene, phosphamide, dichlorophosphate;
• srednetoksichnye - trichlorfon, malathion, metilnitrofos le bolaeang likokoanyana e thehiloeng bona, hammoho le sayfos, cyanophos, tribufos;
• tlase toxicity - demufos, bromophos, temephos.

Matšoao a chefo FOS

Ho ea ka tekanyo e oa chefo ea matla a khoheli a arotsoe ka mekhahlelo e 3. Clinic organophosphate chefo e tjena:

Maikutlo a botahoa (Ke sethaleng):

• psychomotor pherekano le boikutlo tšabo;
• bokhutšoanyane phefumoloho;
• barutoana dilated (miosis);
• spastic bohloko mpeng ea;
• eketseha salivation le ho hlatsa;
• hlooho haholo;
• phahameng khatello ea mali;
• profuse fufuleloa;
• wheezing.

Ka mofuta o itekanetseng (II sethaleng):

• pherekano ka ho hlokomelwa kapa butle-butle nkeloa sebaka thibelo, 'me ka linako tse ling - le coma;
• tshwaileng e miosis, thaka ho khanya ba hlōleha ho ho arabela ka;
• maximally bonahatsa matšoao a hyperhidrosis (meaho salivation (mathe), ho fufuleloa, bronhoreya (tlala likhohlela tloha bronchi));
• fibrillar twitching dintshi, mesifa ea sefuba, maoto, 'me ka linako tse ling kaofela ha mesifa ea;
• nako le nako ho hlaha ha e kholo mesifa palo yohle mele, tonic tsitsipana;
• ka tsela e hlollang eketsa molumo oa sefuba;
• khatello ea mali fihla tshebetso lebetsoeng le (250/160);
• involuntary defecation le ho ntša metsi, a tsamaea le bohloko tenesmus (litakatso ba bohata).

Haholo chefo (III sethaleng):

• mokuli oela ka coma tebileng;
• reflexes tsohle li fokola kapa le sieo ka ho feletseng;
• haholo hypoxia;
• bitsoa miosis;
• pholosa matšoao a hyperhidrosis;
• Phetoho ea mesifa hypertonus, miofibrillyatsii le tsitsipana tonic shoeleng litho mesifa boikhathollo;
• ka matla tepeletseng maikutlo respiration botebo le maqhubu a ya breaths ba kamehla, ho ka etsahala ho hema shoele litho;
• ho otla ha pelo e theolela ho litsupa mahlonoko tseo ho leng (mets 40-20.);
• tachycardia ntlafatsoa (tse fetang 120 otla ka mets.);
• khatello ea mali o tsoela pele ho a oa;
• ho ntshetsa pele magazine nang le chefo e ka edema le hemorrhages tse ngata diapedetic mofuta ka go tlhaolega e tsoakiloeng, ka lebaka la ho holofala ha mesifa ho hema le thibelo ea setsi sa matšoafo;
• letlalo ho panya ha leihlo fela bonahala cyanosis (letlalo le lera la mucous ba type genus mala).

Liphello tsa ho se bolaeang likokoanyana chefo phosphorus

Ha 'mele o oela organophosphorus metsoako, thuso ea pele le fetoletsoeng e le ka potlako le ka tsela e loketseng, ke o mong oa mekhoa e ka sehloohong eo fumana tsela e' ngoe ea lefu lena. FOS botahoa tepelletse maikutlong ke batlang e le bonolo ho beha ka bath setshwantsho ea tleleniki Leha ho le joalo, ke hore na sephetho sa tšoanelang kapa lehlatsipa shoa, itšetlehile haholo ka se latele-up ea meriana.

Ka lebaka la ho toxicity phahameng tsa metsoako organophosphorus ha ingested ke tsa ntša kotsi irreparable hoo e ka bang tsohle makala a ea bohlokoa le tsamaiso ea. Tabeng ena, esita le le phello e molemo ho ba tsosolosa ka botlalo ho sebetsa ha makala itseng e hlōleha.

Har'a mathata, e leng hangata tsamaea le botahoa hampe ke metsoako organophosphorus kenyeletsa serame sa matšoafo, arrhythmias cardiac le conduction cardiac, ntho-hlohlelletsoa psychosis ka mokgwa hlobaetsang, joalo-joalo

lefu lena

Matsatsing a seng makae pele ka mor'a chefo e, e le mamello e le boemong bo e tebileng a bakoang ke ho putlama pelo le methapo. Joale ho tla latela puseletso e butle-butle le ho ntlafatsa bophelo bo botle. Leha ho le joalo, ka mor'a libeke tse 2-3, ho ka etsahala ho hōla ha matla polyneuropathy nang le chefo e. Maemong a mang, tshebetso ka amehang a 'maloa a methapo cranial.

Nakong tsena polyneuropathy hamorao lekaneng ka nako e telele, ka linako tse ling a tsamaea le mafu a mokhatlo oa leqoophe. Khutlisa mesebetsi ya tsamaiso ea methapo pheriferale sebe. Ho ka 'na boela la hlaha ho khutla ha mafu a hlobaetsang le, tse kang maqakabetsi cholinergic. Lebaka le leng ke hore beha organophosphorus komponeng "tsoibitsoe" ho tloha lisele tse sa tšoaneng ka tsamaiso ea ho potoloha ha mali.

kalafo

Ha ha chefo e le tse tebileng ke metsoako organophosphorus, thuso ea pele ba lokela ho kenyeletsa le mabifi ho hloekisa pampitšaneng ena tshilong ya dijo ka ho lavage gastric sebelisa fatang qobelloa diuresis, joalo-joalo, tlhokomelo ya respiration le ho sebelisa antidotes itseng. Ho feta moo, e rarahaneng ea resuscitation, ho akarelletsa le pharmacotherapy, ikemiseditse ho ho boloka le ho tsosolosa mesebetsi 'mele senyehile, ho akarelletsa le mehato ea ho tsosolosa mosebetsi cardiac, kalafo ea mafu a ya homeostasis le exotoxic makala.

Tsosoloso ea mosebetsi matšoafo

Organophosphorus metsoako qabeletsoe 'meleng ka bongata, hangata ba bakela tsieleho matšoafo, a bakoa ke tsela e feteletseng oropharyngeal secretion, le bronchoconstriction shoele litho tsa mesifa matšoafo. Mabapi le sena, ntho ea pele eo lingaka li leka ho etsa - ke ho tsosolosa airway le netefatsa ventilation lekaneng. Ka ho ba teng ha vomitus le ngata le ho tebelwa mosebetsing oropharyngeal, e sebetsa aspiration (ja ya sephalli ke lephaka). Ka chefo hlobaetsang FOS resuscitation kenyeletsa endotracheal intubation, phetha molao ventilation.

phekolo pheko ea

Kopo safeners (antidotes) ke karolo ea bohlokoa ea pharmacotherapy tshohanyetso ka chefo a hlobaetsang. Lithethefatsi sehlopheng sena ama kinetics e teng 'meleng oa dintho nang le chefo e, fana absorption lona kapa felisoa, phello e ka tlaase ka receptors toxin thibela chesa kotsi le ho felisa mafu a kotsi ya mesebetsi ea bohlokoa' mele, e bakoang ke botahoa.

Pheko ea ho chefo ke organophosphorus metsoako nkiloeng hammoho lithethefatsi tse ling tse khethehileng. Pharmacotherapy e neng e tšoaretsoe e tšoanang le resuscitation kakaretso le mehato detoxifying phekolo.

E lokela ho a hopola hore ha ho na monyetla oa ho resuscitation hang-hang, bophelo ba lehlatsipa la ka pholosoa feela pheko ea metsoako organophosphorus, 'me kapele ho e hlahiswa, monyetla le lehlatsipa tla ba le phello e molemo ka lefu lena.

tlhophiso ea antidotes

Antidotes ba classified ka lihlopha tse 'nè:

• bontshang matshwao (diokobatsi);
• skeletal (toxicokinetic);
• lik'hemik'hale (toksikotropnye);
• antitoxic Immunopreparat.

Ha matšoao a pele ya chefo organophosphate, leha ho le joalo ka mohato dogospitalizatsii lehlatsipa, 'me sebelisa pheko ea bontshang matshwao lihlopha toksikotropnoy, kaha ba na le pontšo e hlakileng bakeng sa tšebeliso e. Litokisetso bohato toxicokinetic hloka ho khomareloe ka thata-thata ho litaelo, hobane lingaka ambulense ka hase kamehla ka tsela e nepahetseng beha matšoao lebaka la ho sebelisa. Antitoxic Immunopreparat sebelisoa ka mokgatlo ea tsa bongaka.

phekolo e itseng ka ho chefo a hlobaetsang ka metsoako organophosphorus

liketsahalo tse rarahaneng kenyelletsa ditokiseletso sebelisa anticholinergics (atropine mofuta meriana) hammoho le cholinesterase reactivator. Ka hora ea pele ka mor'a bookelong khanna atropine matla. Atropine ka tekanyetso e kholo e laolwa entoe ho ea liphallelo tsa matšoao a hyperhidrosis fumaneha. Lokela ho boela ho be le matšoao a ho overdose fokolang ea lithethefatsi, a bolela hore letlalo omeletseng le e tachycardia itekanetseng.

Ho boloka ena boemong ba ho atropine e laolwa ho pheta-pheta, empa tekanyetso e nyenyane. Tšehetsang atropinization baka e thibela likepe leqoophe ea litsamaiso limithara-cholinoreactive senyehile-ba khahlanong le lithethefatsi ea 'mele ea ketso ea acetylcholine ka nako hlokahalang bakeng sa timetso le ho felisoa ha chefo.

Morao-rao Reaktivatory cholinesterase kgona ho ka katleho matlafatsa hateletsoeng cholinesterase le kokobetsa ho metsoako e sa tšoaneng phosphorus. Ho phetha phekolo e itseng a ntse a leihlo mosebetsi kamehla cholinesterase.