Yintoni inkqubo ye-sodium thiosulfate ekunyangeni ityhefu ye-cyanide?

Ityhefu yeCyanide yimeko embi kakhulu nesongela ubomi efuna unyango olukhawulezileyo. I-Sodium thiosulfate yenye yamayeza aphambili asetyenziswa kunyango lweCyanide Poisoning . Eli nqaku liza kuhlola inkqubo eneenkcukacha zendlela iSodium Thiosulfate esebenza ngayo ukulwa nemiphumo yeCyanide.

Ukuqonda iCyanide Poisoning

I-Cyanide yinto enetyhefu kakhulu. Xa ingena emzimbeni, ikhawuleza idibanise kwi-cyanide ions (CN⁻). Ezi ion zinobudlelwane obuphezulu be-ion ye-ferric (Fe³⁺) kwi-cytochrome oxidase, i-enzyme ebalulekileyo yokuphefumla kweselula. Ngokuzibophelela kwi-cytochrome oxidase, i-cyanide inqanda ikhonkco lokuthutha i-electron, ikhusela iiseli ekusebenziseni i-oksijini ngokufanelekileyo. Ngenxa yoko, iiseli azikwazi ukuvelisa i-adenosine triphosphate (ATP), imali yamandla eseli, ekhokelela ekufeni ngokukhawuleza kweeseli. Iimpawu zetyhefu yecyanide zinokubandakanya intloko ebuhlungu, isiyezi, ukuphefumla ngokukhawuleza, isicaphucaphu, ukugabha, kwaye kwiimeko ezinzima, ukulahlekelwa zingqondweni, ukuxhuzula nokufa.

Indima yeSodium Thiosulfate kuNyango

Indlela yokuSebenza

I-sodium thiosulfate isebenza njengomnikeli wesulfure. Xa kukho i-enzyme rhodanese, ekhoyo kwisibindi kunye nezinye izicubu, i-sodium thiosulfate isabela kunye ne-cyanide ions. I-athomu yesulfure evela kwi-sodium thiosulfate idluliselwa kwi-ion cyanide, iguqule ibe yi-thiocyanate (SCN⁻). I-Thiocyanate ayinabungozi kakhulu kune-cyanide kwaye inokukhutshelwa ngokukhuselekileyo emzimbeni ngezintso.

Ukusabela kweekhemikhali kunokubonakaliswa ngolu hlobo lulandelayo:

CN⁻ + Na₂S₂O₃ → SCN⁻ + Na₂SO₃

Le nkqubo yokuguqula inceda ekunciphiseni ukuxinana kwee-ion ze-cyanide ezinetyhefu emzimbeni, evumela ukuphefumla okuqhelekileyo kweselula ukuba kuqalise kwakhona.

Ulawulo kuNyango

Xa kunyangwa ityhefu ye-cyanide, i-sodium thiosulfate ilawulwa nge-intravenously. Kubantu abadala, umthamo wokuqala oqhelekileyo ngu-12.5 - 25 grams (ngokuqhelekileyo njengesisombululo se-25% - 50%). Oku kudla ngokulandelwa ngamadosi awongezelelweyo njengoko kufuneka, ngokuxhomekeke kubunzulu betyhefu kunye nempendulo yesigulana. Ngokomzekelo, kwezinye iimeko, umthamo wesibini we-25 - 50 grams (50% isisombululo) unokunikwa, okanye umthamo unokubalwa ngokusekelwe kubunzima bomzimba wesigulane kwi-0.5 - 1 gram ngekhilogram yobunzima bomzimba.

Kubantwana, umthamo ubalwa ngokusekelwe kubunzima bomzimba, ngokuqhelekileyo kwi-250 - 500 milligrams ngekhilogram. Iyeza lilawulwa ngokucothayo ukuthintela iziphumo ebezingalindelekanga ezifana ne-hypotension (uxinzelelo lwegazi oluphantsi), enokuthi yenzeke ukuba itofwe ngokukhawuleza.

Ukudityaniswa nolunye unyango

I-sodium thiosulfate isoloko isetyenziswa kunye nolunye unyango lwetyhefu yecyanide. Enye yezona zinto zixhaphakileyo zidibanisa i-nitrites, njenge-sodium nitrite okanye i-amyl nitrite. I-nitrites isebenza ngokuguqula i-hemoglobin ibe yi-methemoglobin. I-Methemoglobin inobudlelwane obuphezulu be-cyanide ion kune-cytochrome oxidase. Ke, xa i-methemoglobin yenziwa emzimbeni, ii-ion ze-cyanide ziya kuthi zibophe ngokukhethekileyo kuyo, ikhuphe i-cytochrome oxidase kwaye ivumele ukuphefumla kweselula ukuba kuqale kwakhona. Nangona kunjalo, i-cyanide-methemoglobin complex ayizinzanga, kwaye i-cyanide inokukhululwa ibuyele egazini ngokuhamba kwexesha. Kulapho i-sodium thiosulfate ingena khona. Ngokuguqula i-cyanide ekhutshwe kwi-cyanide-methemoglobin ibe yi-thiocyanate, i-sodium thiosulfate ibonelela ngesisombululo sexesha elide sokususa i-cyanide emzimbeni.

Ukongeza kwi-nitrites, ezinye iindlela zonyango ezixhasayo zikwabonelelwa. Oku kunokubandakanya unyango oluphezulu lwe-oksijeni yokuphucula ukuhanjiswa kwe-oksijini kwiithishu, kunye nemilinganiselo yokulawula iimpawu ezifana nokuxhuzula, i-hypotension, kunye ne-asidi - ukungalingani kwesiseko esihlala sihamba kunye netyhefu ye-cyanide.

Ukubeka iliso kunye nokulandelela

Emva kokulawulwa kwe-sodium thiosulfate kunye nolunye unyango lwetyhefu ye-cyanide, izigulane kufuneka zibekwe esweni. Ababoneleli bezempilo baya kujonga iimpawu ezibalulekileyo ezifana nesantya sentliziyo, uxinzelelo lwegazi, izinga lokuphefumula, kunye nokugcwala kwe-oxygen rhoqo. Uvavanyo lwegazi lunokuqhutywa ukulinganisa amanqanaba e-cyanide, i-thiocyanate, kunye namanqaku omonakalo wezicubu. Ukongeza, imeko ye-neurological yesigulane iya kujongwa ngokusondeleyo, njengoko ubuthi be-cyanide bunokubangela umonakalo omkhulu kwinkqubo ye-nervous central.

Ukhathalelo lokulandelela nalo lubalulekile. Nokuba isigulana sibonakala sichacha ekuqaleni, kunokubakho iziphumo zexesha elide ezifana nokusilela kwemithambo-luvo okanye ukonakala kwamalungu. Ukuhlolwa rhoqo kunye namanyathelo okubuyisela kwisimo sangaphambili kunokuba yimfuneko ukuze kuqinisekiswe isiphumo esihle kakhulu sesigulane.

Ukuqukumbela, i-sodium thiosulfate idlala indima ebalulekileyo kunyango lwetyhefu ye-cyanide ngokuguqula iiyoni ze-cyanide ezinetyhefu kakhulu zibe yi-thiocyanate engenatyhefu. Ukusetyenziswa kwayo, ngokudibanisa nezinye iindlela zonyango kunye nokubeka iliso ngokufanelekileyo, kunokuphucula kakhulu amathuba okuphila kunye nokubuyisela izigulane ezinetyhefu ye-cyanide.