Chii Chiyero cheKubudirira Kurapa Sodium Cyanide Poisoning?

Sodium cyanide chinhu chine muchetura zvakanyanya, uye Sodium cyanide chepfu injodzi inotyisidzira upenyu. Kubudirira kwehutano hwekurapa kunokanganiswa nezvinhu zvakawanda, uye hapana imwe chete, chaiyo yekubudirira kwehuwandu hunoshanda kune zvese zviitiko.

1. Toxic Mechanism yeSodium Cyanide

Sodium cyanide inoburitswa Cyanide ions (CN⁻) mumuviri. Aya maioni ecyanide ane hukama hwakasimba zvakanyanya kune ferric iron (Fe³⁺) mu cytochrome oxidase mumaseru. Kana yangobatanidzwa, inoumba yakagadzikana yakaoma, iyo inoita kuti cytochrome oxidase irasikirwe nekukwanisa kwayo kutamisa maerekitironi. Somugumisiro, ketani yekutakura erekitironi mumasero inokanganiswa, uye masero haakwanisi kushandisa okisijeni kazhinji, zvichiita kuti intracellular asphyxia. Matishu anomanikidzwa kushandura kubva aerobic metabolism kuenda kune anaerobic metabolism, inoperekedzwa nekuwedzera kwelactate uye inorganic phosphate yemukati mumatissue, uye kuderera kweglycogen uye ATP zvemukati. Sezvo iyo yepakati tsinga system inonyanya kunetseka kune hypoxia, ndiyo yekutanga kukuvadzwa, kunyanya nzvimbo yekufema uye vasomotor centre.

2. Zvinhu Zvinokanganisa Kubudirira Mwero Yekurapa

2.1 Kuoma Kwehupfu

• Mild Poisoning: Muzviitiko zvinyoro Sodium Cyanide chepfu, kana muyero we cyanide wakamwiwa kana kufemurwa uri mudiki, nzira dzemuviri dzinoripira dzingangove dzichikwanisa kushanda kusvika kumwero wakati. Semuenzaniso, varwere vanogona kungoona zviratidzo zvakapfava semusoro, dzungu, kuda kurutsa, uye kupfupika kwekufema. Mumamiriro ezvinhu akadaro, kana ukarapwa nokukurumidza, kubudirira kwokurapa kunenge kwakakwirira. Nekubviswa panguva yakakodzera kubva kune chepfu, kufemerwa neokisijeni, uye kushandiswa kwemishonga yakakodzera, varwere vazhinji vanogona kupora zvachose.

• Muchetura Wakanyanya: Kana muchetura wakanyanya, varwere vanogona kukurumidza kufambira mberi kusvika kune zviratidzo zvakaita sekoma, kugwinha, uye kusungwa kwemoyo uye kufema. Panguva ino, nhengo dzakawanda dzemuviri dzakakuvadzwa zvakanyanya. Semuenzaniso, moyo unogona kumira kurova zvinobudirira, uye uropi hunogona kutambura ne hypoxia yakanyanya - ischemic kukuvara. Iyo nguva yakareba iyi nyika inoramba ichienderera, iyo yakakura dhigirii yekukuvadzwa kwenhengo, uye zvakanyanya kuoma kudzoreredza mamiriro, zvichikonzera kuderedzwa kwakanyanya kwekubudirira kwekurapa.

2.2 Nguva Yehupfu

• Short-term Poisoning: Kana nguva kubva kuitika kwe sodium cyanide chepfu kusvika kutanga kurapwa ipfupi, kukuvadzwa kwemuviri kune zvishoma. Semuenzaniso, kana munhu akanunurwa uye kurapwa mukati memaminitsi mashoma kusvika hafu yeawa mushure mekufema kana kupinza Sodium cyanide, mukana wekubudirira kurapwa wakakura zvikuru. Nekuti panguva ino, iyo cyanide haina kuwana nguva yakakwana yekukonzeresa kukuvadza kusingachinjiki kune nhengo dzinokosha.

• Nguva refu Poisoning: Nokufamba kwenguva, cyanide inoramba ichishanda pamasero, uye kukuvadzwa kwenhengo dzakadai semwoyo, uropi, uye chiropa kunoungana. Kana nguva yechepfu ikadarika maawa akawanda uye murwere asina kuwana kurapwa kunoshanda, chiyero chekupona chinenge chakaderera zvakanyanya. Semuenzaniso, mushure memaawa akawanda ehupfu hwecyanide, uropi hunogona kunge hwakatambura necrosis yakawanda nekuda kwe hypoxia, uye kunyange kana cyanide ikabviswa kubva mumuviri gare gare, kushanda kwehuropi kwakakanganisika kunonetsa kupora.

2.3 Nguva uye Kurongeka kwekutanga - Matanho erubatsiro

• Nguva Yekutanga - Rubatsiro: Pakarepo matanho ekubatsira ekutanga panzvimbo yechepfu anoita basa rakakosha. Kamwe sodium cyanide poisoning ichifungidzirwa, danho rekutanga nderekukurumidza kufambisa murwere kubva munzvimbo ine chepfu kudzivirira kuwedzera kuratidzwa. Semuenzaniso, kana inhalation chepfu mutsaona yemuindasitiri, kuendesa murwere kunzvimbo ine mweya mutsva nekukurumidza sezvinobvira kunogona kuderedza inhalation yekuwedzera cyanide. Panguva imwecheteyo, kudaidza rubatsiro rwekurapa kwekukurumidzira nekukurumidza kwakakosha. Kana kufema kwemurwere kana kurova kwemwoyo kwakamira, kudzorera mwoyo nemapapu (CPR) kunofanira kutangwa pakarepo. Maminiti ese ekunonoka mune yekutanga - rubatsiro matanho anogona kuderedza budiriro yekurapa.

• Yakarurama Kutanga - Rubatsiro: Kururamisa kwekutanga - mashandiro ekubatsira akakosha zvakare. Semuenzaniso, kana uchiita CPR, zvinodikanwa kutevedzera nhanho dzekushanda dzakaringana, kusanganisira chiyero chakaringana chekumanikidzwa kwechipfuva kusvika pakufema kwekugadzira. Pamusoro pezvo, kana murwere akanwa sodium cyanide, nzira dzisina kufanira dzeemetic dzinogona kukonzera shungu uye kuwedzera hupenyu hwemurwere mungozi. Naizvozvo, vabatsiri vekutanga vanofanirwa kudzidziswa kuti vaone kuti matanho ekutanga ekubatsira anoitwa nemazvo.

2.4 Kurapwa muchipatara

• Kushandisa Antidotes: Muchipatara, kushandiswa panguva uye kwakarurama kwemishonga inorwisa mabhakitiriya chinhu chinokosha mukurapa kwesodium cyanide poisoning. Mushonga mukuru wekurapa cyanide chepfu ndeye "nitrite - thiosulfate" therapy. Nitrites (senge sodium nitrite) inogona oxidize chikamu cheyakajairika hemoglobin muropa kuti iite methemoglobin. Methemoglobin ine ferric iron (Fe³⁺), ine hukama hwakasimba hwecyanide ions kupfuura cytochrome oxidase. Nokudaro, inogona kukwikwidzana ne cytochrome oxidase ye cyanide ions, ichisunga cyanide ions kuti iite cyanmethemoglobin, nokudaro kubvisa inhibitory effect ye cyanide ions pa cytochrome oxidase. Zvadaro, thiosulfate inoshandiswa. Pasi pekuita kwe rhodanese enzyme yemuviri, thiosulfate inosangana ne cyanide ions kuumba isiri-chepfu thiocyanate, iyo inoburitswa kubva mumuviri neweti. Kana mushonga wacho uchigona kushandiswa nenguva zvichienderana nemamiriro emurwere, kubudirira kwekurapa kuchavandudzwa zvakanyanya.

• Comprehensive Treatment: Pamusoro pekushandiswa kwemaantidotes, matanho ekurapa akakwana anodiwa zvakare. Izvi zvinosanganisira kuchengetedza zviratidzo zvinokosha zvemurwere, zvakadai sekuona kufema kwakadzikama kuburikidza nemagetsi emhepo kana zvichidiwa, kuchengetedza ropa rinowanzoitika kuburikidza nekugadzirisa mvura uye vasoactive mishonga, nekudzivirira nekurapa matambudziko akadai secerebral edema. Semuenzaniso, kushandiswa kweglucocorticoids, hypertonic glucose, uye vitamin C kunogona kubatsira kuderedza cerebral edema. Kana aya matanho ekurapa akazara akashandiswa zvinobudirira, zvichabatsirawo mukuvandudza mwero wekubudirira kwekurapa.

3. General Estimation of Treatment Success Rate

Kazhinji, kana chepfu iri munyoro, murwere anorapwa nokukurumidza (kazhinji mukati maminitsi 30 kusvika 1 awa pashure chepfu), uye yose kurapa muitiro, kusanganisira chokutanga - rubatsiro panguva yechiitiko uye kurapwa muchipatara, inoitwa zvakarurama, chiyero chekubudirira kwekurapa kunogona kunge kwakakwirira, zvichida kusvika kune 80% mune dzimwe nguva. Zvisinei, kune zviitiko zvakakomba, kunyanya avo vane nguva yakareba yechepfu (kupfuura 2 - 3 maawa) uye kurapwa kunonoka, kubudirira kwekurapa kunogona kunge kuri pasi pe20%, uye mune dzimwe nguva dzakaoma zvikuru, murwere angasakwanisa kuponeswa pasinei nekuedza kwose.

Mukupedzisa, chiyero chekubudirira kwekurapa sodium cyanide chepfu inosiyana zvakanyanya zvichienderana nezvakawanda zvinhu. Chinokosha chekuvandudza chiyero chekubudirira chiri mukudzivirira kwekutanga, panguva yakakodzera uye yakarurama yekutanga - rubatsiro panzvimbo, uye kurapa kwakakwana uye kunoshanda muchipatara.