Chii Chiyero cheKubudirira Kurapa Sodium Cyanide Poisoning?

Sodium cyanide chinhu chine chepfu yakawanda, uye chepfu yeSodium cyanide idambudziko guru rinotyisidzira hupenyu. Kubudirira kwekurapwa kunokanganiswa nezvinhu zvakawanda, uye hapana nhamba imwe chete chaiyo yekubudirira inoshanda kune vese varwere.

1. Toxic Mechanism yeSodium Cyanide

Sodium cyanide inoburitsa maion eCyanide (CN⁻) mumuviri. Maion aya eCyanide ane hukama hwakasimba neferric iron (Fe³⁺) iri mucytochrome oxidase mumasero. Kana yabatanidzwa, inoumba complex yakagadzikana, izvo zvinoita kuti cytochrome oxidase irasikirwe nekugona kwayo kutamisa maerekitironi. Nekuda kweizvozvo, cheni yekufambisa maerekitironi mumasero inokanganiswa, uye masero haakwanise kushandisa okisijeni zvakanaka, zvichikonzera kushaya simba mukati memasero. Matsue anomanikidzwa kuchinja kubva pakuchinja kwe aerobic kuenda kukusashanda kwe anaerobic, pamwe nekuwedzera kwe lactate ne inorganic phosphate mumatishu, uye kudzikira kwe glycogen ne ATP. Sezvo system yepakati yetsinga ichinyanya kunzwa hypoxia, ndiyo yekutanga kukuvara, kunyanya nzvimbo yekufema ne vasomotor centre.

2. Zvinhu Zvinokanganisa Kubudirira Mwero Yekurapa

2.1 Kuoma Kwehupfu

• Chepfu Isina Kuipa : Kana paine chepfu yeSodium Cyanide isina kuipa, kana dosi yecyanide yakadyiwa kana kufemerwa iri diki, mashandiro emuviri anogona kuramba achikwanisa kushanda kusvika pamwero wakati. Semuenzaniso, varwere vanogona kungoona zviratidzo zvidiki zvakaita semusoro, dzungu, kuda kurutsa, uye kufema zvishoma. Muzviitiko zvakadaro, kana zvikarapwa nekukurumidza, mwero wekubudirira kwekurapwa unenge wakakwira. Nekubviswa kwechepfu panguva yakakodzera, kufemerwa kweokisijeni, uye kushandiswa kwemishonga yakakodzera, varwere vazhinji vanogona kupora zvachose.

• Kuchetura Zvakanyanya : Kana chepfu yacho yakanyanya, varwere vanogona kukurumidza kukura kusvika pazviratidzo zvakaita sekoma, kugwinha, uye kumira kwemoyo nekufema. Panguva ino, nhengo dzakawanda mumuviri dzinokuvadzwa zvakanyanya. Semuenzaniso, moyo unogona kumira kurova zvinobudirira, uye uropi hunogona kutambura nekushaya hope kwakanyanya - kukuvara kweischemic. Kana mamiriro aya akaramba kwenguva refu, kukuvara kwenhengo kunowedzera, uye zvinova zvakaoma kugadzirisa mamiriro acho ezvinhu, zvichikonzera kudzikira kukuru kwekubudirira kwekurapwa.

2.2 Nguva Yehupfu

• Chepfu Yenguva Pfupi : Kana nguva kubva pakuonekwa kwechepfu ye sodium cyanide kusvika pakutanga kwekurapwa iri pfupi, kukuvara kwemuviri kushoma. Semuenzaniso, kana munhu akanunurwa ndokurapwa mukati memaminitsi mashoma kusvika hafu yeawa mushure mekufema kana kunwa Sodium cyanide , mukana wekubudirira kurapwa wakakwira zvikuru. Nekuti panguva ino, cyanide haina kuwana nguva yakakwana yekukonzera kukuvara kusingagadzirisiki kunhengo dzakakosha.

• Chepfu Yenguva Refu : Nekufamba kwenguva, cyanide inoramba ichishanda pamasero, uye kukuvara kwenhengo dzakadai semwoyo, uropi, nechiropa kunoungana. Kana nguva yechepfu ikapfuura maawa akati wandei uye murwere asina kurapwa zvakanaka, mwero wekurarama uchava wakaderera zvikuru. Semuenzaniso, mushure memaawa akati wandei echepfu yakanyanya yecyanide, uropi hunogona kunge hwakatambura necrosis yakakura nekuda kwekushaya hope, uye kunyangwe cyanide ikabviswa mumuviri gare gare, mashandiro europi akakuvara anonetsa kupora.

2.3 Nguva uye Kurongeka kwekutanga - Matanho erubatsiro

• Rubatsiro Rwekutanga Nenguva : Matanho ekutanga ekubatsira vanhu nekukurumidza panzvimbo yakabatwa chepfu anoita basa rakakosha. Kana paine kufungidzirwa kuti chepfu ye sodium cyanide, danho rekutanga nderekukurumidza kubvisa murwere munzvimbo ine chepfu kudzivirira kuti arambe achibatwa. Semuenzaniso, kana paine chepfu yekufema mutsaona yemuindasitiri, kuendesa murwere kunzvimbo ine mhepo itsva nekukurumidza kunogona kuderedza kufema kwe cyanide yakawedzerwa. Panguva imwe chete, kufonera rubatsiro rwekurapa nekukurumidza kwakakosha. Kana kufema kwemurwere kana kurova kwemoyo kwamira, cardiopulmonary resuscitation (CPR) inofanira kutanga nekukasika. Miniti yega yega yekunonoka kwematanho ekutanga ekubatsira vanhu inogona kuderedza mwero wekubudirira kwekurapwa.

• Rubatsiro Rwekutanga Rwakarurama : Kurapa kwekutanga kwakarurama kwakakoshawo. Semuenzaniso, pakuita CPR, zvakakosha kutevedzera matanho akakodzera ekuvhiya, kusanganisira chiyero chakakodzera chekudzvanywa kwechipfuva nekufema kwekugadzira. Pamusoro pezvo, kana murwere anwa sodium cyanide, nzira dzisina kunaka dzekubuda ropa dzinogona kukonzera kusvuta uye kuisa hupenyu hwemurwere panjodzi. Nokudaro, vabatsiri vekutanga vanofanirwa kudzidziswa kuona kuti matanho ekutanga ekubatsira anoitwa nemazvo.

2.4 Kurapwa muchipatara

• Kushandisa Mishonga Inorwisa : Muchipatara, kushandiswa kwemishonga iyi panguva yakakodzera uye nemazvo chinhu chakakosha pakurapa chepfu ye sodium cyanide. Mushonga mukuru wekurapa chepfu ye cyanide imishonga inonzi "nitrite - thiosulfate". MaNitrites (akadai se sodium nitrite) anogona kuoxidize chikamu che hemoglobin yakajairika muropa kuenda ku methemoglobin. Methemoglobin ine ferric iron (Fe³⁺), iyo ine simba rakasimba remaion e cyanide kupfuura cytochrome oxidase. Nokudaro, inogona kukwikwidzana ne cytochrome oxidase ye maion e cyanide, ichisunga maion e cyanide kuti iumbe cyanmethemoglobin, nokudaro ichideredza simba remaion e cyanide pa cytochrome oxidase. Zvadaro, thiosulfate inoshandiswa. Pasi pekushanda kwe rhodanese enzyme yemuviri, thiosulfate inobatana nemaion e cyanide kuti iumbe thiocyanate isina chepfu, iyo inoburitswa mumuviri nemuto. Kana mushonga uyu ukashandiswa nenguva zvichienderana nemamiriro emurwere, huwandu hwekubudirira kwekurapwa huchavandudzika zvakanyanya.

• Kurapa Kwakakwana : Pamusoro pekushandisa mishonga inorwisa utachiona, matanho ekurapa akazara anodiwawo. Izvi zvinosanganisira kuchengetedza zviratidzo zvinokosha zvemurwere, zvakaita sekusimbisa kufema kwakasimba kuburikidza nemhepo inofefetera kana zvichidikanwa, kuchengetedza BP yakajairika kuburikidza nekutsiva mvura uye mishonga inosimbisa ropa, uye kudzivirira nekurapa matambudziko akadai se cerebral edema. Semuenzaniso, kushandisa glucocorticoids, hypertonic glucose, uye vhitamini C kunogona kubatsira kuderedza cerebral edema. Kana matanho aya ekurapa akazara akashandiswa zvinobudirira, zvichabatsirawo mukuvandudza mwero wekubudirira kwekurapwa.

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.