Dab tsi yog Qhov Kev Ua Tau Zoo ntawm Kev Kho Sodium Cyanide Poisoning?

sodium cyanide yog ib yam tshuaj lom heev, thiab Sodium cyanide lom yog lub neej muaj kev kub ntxhov. Qhov kev vam meej ntawm kev kho mob yog cuam tshuam los ntawm ntau yam, thiab tsis muaj ib qho, qhov tseeb tus lej ua tiav siv tau rau txhua kis.

1. Toxic Mechanism ntawm Sodium Cyanide

Sodium cyanide tso tawm Cyanide ions (CN⁻) hauv lub cev. Cov cyanide ions no muaj kev sib raug zoo heev rau ferric hlau (Fe³⁺) hauv cytochrome oxidase hauv hlwb. Ib zaug ua ke, lawv tsim ib qho chaw ruaj khov, uas ua rau cytochrome oxidase poob nws lub peev xwm hloov hluav taws xob. Raws li qhov tshwm sim, cov saw hlau thauj hluav taws xob hauv cov hlwb raug cuam tshuam, thiab cov hlwb tsis tuaj yeem siv oxygen ib txwm, ua rau intracellular asphyxia. Cov ntaub so ntswg raug yuam kom hloov los ntawm aerobic metabolism mus rau anaerobic metabolism, nrog rau kev nce hauv lactate thiab inorganic phosphate cov ntsiab lus hauv cov ntaub so ntswg, thiab txo qis hauv glycogen thiab ATP cov ntsiab lus. Txij li thaum lub hauv nruab nrab lub paj hlwb yog tshwj xeeb tshaj yog rhiab heev rau hypoxia, nws yog thawj zaug uas yuav raug puas tsuaj, tshwj xeeb tshaj yog nyob rau hauv lub pa center thiab vasomotor center.

2. Tej yam cuam tshuam rau kev ua tau zoo ntawm kev kho mob

2.1 Kev Ua Phem Txhaum Cai

• Mob me me: Thaum mob me Sodium Cyanide lom, yog tias koob tshuaj cyanide noj lossis nqus tau me me, lub cev lub cev cov txheej txheem tseem tuaj yeem ua haujlwm rau qee yam. Piv txwv li, cov neeg mob tsuas muaj cov tsos mob me xws li mob taub hau, kiv taub hau, xeev siab, thiab ua tsis taus pa. Hauv cov xwm txheej zoo li no, yog tias kho tam sim ntawd, qhov ua tiav ntawm kev kho mob yog qhov siab. Nrog rau kev tshem tawm raws sij hawm los ntawm qhov chaw lom, nqus pa oxygen, thiab siv cov tshuaj tua kab mob uas tsim nyog, feem ntau cov neeg mob tuaj yeem rov zoo tag nrho.

• Mob hnyav heev: Thaum cov tshuaj lom hnyav heev, cov neeg mob tuaj yeem ua rau cov tsos mob xws li coma, convulsions, thiab mob plawv thiab ua pa. Lub sijhawm no, ntau yam kabmob hauv lub cev raug puas tsuaj loj. Piv txwv li, lub plawv tuaj yeem nres ua haujlwm zoo, thiab lub hlwb yuav raug kev txom nyem los ntawm hypoxia - kev raug mob ischemic. Lub xeev no txuas ntxiv mus ntev, qhov ntau dua qhov kev puas tsuaj ntawm lub cev, thiab qhov nyuaj dua nws yog rov qab tus mob, ua rau txo qis kev kho mob zoo.

2.2 Lub Sijhawm Ua Phem

• Short-term Poisoning: Yog lub sij hawm los ntawm qhov tshwm sim ntawm sodium cyanide lom rau qhov pib ntawm kev kho mob yog luv luv, kev puas tsuaj rau lub cev yog qhov txwv. Piv txwv li, yog tias ib tug neeg tau txais kev cawmdim thiab kho tsis pub dhau ob peb feeb mus rau ib nrab teev tom qab nqus tau lossis nqus tau. Sodium cyanide, txoj hauv kev ntawm kev kho kom zoo yog ntau dua. Vim tias lub sijhawm no, cyanide tsis muaj sijhawm txaus los ua kom tsis muaj kev puas tsuaj rau cov kabmob tseem ceeb.

• Long-term Poisoning: Raws li lub sijhawm dhau mus, cyanide tseem ua rau cov hlwb, thiab kev puas tsuaj rau cov kabmob xws li lub plawv, lub hlwb, thiab daim siab ntau ntxiv. Yog tias lub sijhawm tshuaj lom ntau tshaj li ob peb teev thiab tus neeg mob tsis tau txais kev kho mob zoo, qhov ciaj sia taus yuav tsawg heev. Piv txwv li, tom qab ob peb teev ntawm cov tshuaj lom cyanide hnyav, lub hlwb yuav raug kev txom nyem ntau yam necrosis vim hypoxia, thiab txawm tias cov cyanide raug tshem tawm ntawm lub cev tom qab, lub hlwb puas ua haujlwm tsis yooj yim kom rov zoo.

2.3 Sijhawm Sijhawm thiab Kev Ua Haujlwm Zoo ntawm Thawj - Kev Pabcuam

• Sijhawm Ua Ntej - Pab: Tam sim ntawd ua ntej - kev pab ntsuas ntawm qhov chaw ntawm kev lom neeg ua si lub luag haujlwm tseem ceeb. Thaum xav tias sodium cyanide lom, thawj kauj ruam yog txav tus neeg mob kom deb ntawm ib puag ncig lom kom tsis txhob kis tau ntxiv. Piv txwv li, nyob rau hauv cov ntaub ntawv ntawm inhalation lom nyob rau hauv ib tug muaj kev huam yuaj, tsiv tus neeg mob mus rau ib qho chaw uas muaj huab cua ntshiab sai li sai tau yuav txo tau qhov nqus ntawm cyanide ntxiv. Nyob rau tib lub sijhawm, hu rau kev pabcuam khomob xwm txheej ceev ceev yog qhov tseem ceeb. Yog tias tus neeg mob ua pa lossis lub plawv dhia tau nres, cardiopulmonary resuscitation (CPR) yuav tsum tau pib tam sim ntawd. Txhua feeb ntawm ncua sij hawm ua ntej - kev pab cuam yuav txo tau qhov kev ua tiav ntawm kev kho mob.

• Kho First - Aid: Kev kho thawj zaug - kev pab cuam tseem ceeb heev. Piv txwv li, thaum ua CPR, nws yog ib qho tsim nyog yuav tsum ua raws li cov kauj ruam ua haujlwm kom raug, suav nrog qhov tseeb piv ntawm lub hauv siab compressions rau kev ua pa. Tsis tas li ntawd, yog tias tus neeg mob tau noj cov tshuaj sodium cyanide, cov txheej txheem emetic tsis zoo yuav ua rau muaj kev xav thiab ua rau tus neeg mob lub neej txaus ntshai. Yog li ntawd, thawj - aiders yuav tsum tau cob qhia kom paub tseeb tias qhov kev pab cuam thawj zaug tau ua tiav lawm.

2.4 Kev Kho Mob hauv Tsev Kho Mob

• Kev siv Antidotes: Hauv tsev kho mob, kev siv tshuaj tua kab mob raws sij hawm thiab raug yog qhov txuas tseem ceeb hauv kev kho cov tshuaj sodium cyanide lom. Kev kho mob tseem ceeb rau kev ua xua rau cyanide yog kev kho "nitrite - thiosulfate". Nitrites (xws li sodium nitrite) tuaj yeem oxidize ib feem ntawm hemoglobin hauv cov ntshav mus rau methemoglobin. Methemoglobin muaj ferric hlau (Fe³⁺), uas muaj zog affinity rau cyanide ions tshaj cytochrome oxidase. Yog li, nws tuaj yeem sib tw nrog cytochrome oxidase rau cyanide ions, khi cyanide ions los ua cyanmethemoglobin, yog li txo qis cov nyhuv inhibitory ntawm cyanide ions ntawm cytochrome oxidase. Tom qab ntawd, thiosulfate yog siv. Nyob rau hauv qhov kev txiav txim ntawm lub cev rhodanese enzyme, thiosulfate reacts nrog cyanide ions los ua non-toxic thiocyanate, uas yog tawm ntawm lub cev nrog zis. Yog tias cov tshuaj tiv thaiv tuaj yeem siv tau raws sijhawm raws li tus neeg mob tus mob, qhov ua tiav ntawm kev kho mob yuav zoo dua.

• Kev Kho Kom Zoo: Ntxiv nrog rau kev siv tshuaj tua kab mob, kev ntsuas kev kho mob kuj tseem xav tau. Qhov no suav nrog kev tswj hwm tus neeg mob cov cim tseem ceeb, xws li ua kom muaj kev ruaj ntseg ua pa los ntawm kev siv tshuab ua pa yog tias tsim nyog, tswj cov ntshav siab los ntawm kev hloov cov kua dej thiab cov tshuaj vasoactive, thiab tiv thaiv thiab kho cov teeb meem xws li cerebral edema. Piv txwv li, daim ntawv thov ntawm glucocorticoids, hypertonic qabzib, thiab vitamin C tuaj yeem pab txo qis cerebral edema. Yog tias cov kev ntsuas kev kho mob dav dav no tau siv tau zoo, nws tseem yuav ua rau kev txhim kho kev ua tiav ntawm kev kho mob.

3. Kev kwv yees dav dav ntawm kev kho mob zoo

Feem ntau, yog tias cov tshuaj lom me me, tus neeg mob tau kho tam sim ntawd (feem ntau li ntawm 30 feeb mus rau 1 teev tom qab tshuaj lom), thiab tag nrho cov txheej txheem kho mob, suav nrog kev pabcuam thawj zaug thiab kev kho mob hauv tsev kho mob tau ua tiav, qhov ua tiav ntawm kev kho mob tuaj yeem siab, tej zaum nce mus txog 80% hauv qee kis. Txawm li cas los xij, rau cov mob hnyav, tshwj xeeb tshaj yog cov uas muaj lub sij hawm lom ntev ntev (ntau tshaj 2 - 3 teev) thiab kev kho mob lig, qhov kev kho tau zoo yuav tsawg dua 20%, thiab qee qhov mob hnyav heev, tus neeg mob yuav tsis muaj peev xwm cawm tau txawm tias tag nrho cov kev siv zog.

Hauv kev xaus, qhov kev vam meej ntawm kev kho tshuaj sodium cyanide lom nws txawv heev nyob ntawm ntau yam. Tus yuam sij rau kev txhim kho qhov kev vam meej yog nyob rau hauv kev tiv thaiv thaum ntxov, raws sijhawm thiab raug ua ntej - kev pab ntawm qhov chaw, thiab kev kho mob dav dav hauv tsev kho mob.