Ethylene glycol lom yog qhov tshwm sim heev. Qhov no feem ntau tshwm sim rau cov neeg uas tsim txom cov dej cawv, tshwj xeeb tshaj yog nyob rau sab qaum teb ntawm lub tebchaws. Cov tshuaj lom no txaus ntshai heev vim nws tuaj yeem ua rau tuag taus.
Cov khoom ntawm cov tshuaj lom neeg thiab nws siv
Tshuaj formula of the compound CH2(OH)2. Lub cev, ethylene glycol yog cov kua uas tsis muaj xim uas muaj qhov qab zib thiab yooj yim soluble hauv cov dej cawv. Cov tshuaj no reacts zoo nrog cov organic acids, raws li qhov tshwm sim ntawm cov tshuaj tiv thaiv, volatile esters raug tsim, uas tuaj yeem lom neeg thaum nqus tau.
Ethylene glycol yog siv rau hauv cov haujlwm hauv qab no ntawm tib neeg:
- ntau lawm ntawm dynamite, uas khaws cov khoom ua haujlwm ntawm qhov kub thiab txias;
- tsim tshuaj tiv thaiv kab mob - txias rau lub tsheb;
- tsim cov electrolyte rau ntau lub capacitors;
- tsim cov yas thiab cellophane;
- tsim cov xim thiab cov kuab tshuaj rau lawv;
- tshuaj thiab textile kev lag luam, thiabtshuaj tsw qab.
Cov neeg haus cawv feem ntau paub txog cov tshuaj tiv thaiv kab mob, uas yog sib xyaw ntawm ethylene glycol thiab ethanol. Ntau tus neeg uas quav cawv feem ntau siv nws los rho cawv. Qhov tseeb no yog txuam nrog feem ntau ntawm ethylene glycol lom. Nco ntsoov tias muaj pes tsawg leeg ntawm cov tshuaj tiv thaiv kab mob, ntxiv rau cov tshuaj no, suav nrog ntau yam additives uas txhim kho qhov teeb meem ntawm cov kua dej hauv lub cev. Yog li, kev siv cov khoom siv tshuaj tiv thaiv tsis tu ncua ua rau tsis pom kev.
Cov nyhuv ntawm ethylene glycol ntawm cov txheej txheem hauv lub cev
Yog tias tsuas yog 100 ml ntawm cov tshuaj no nkag mus rau tib neeg lub cev, qhov koob tshuaj no yuav ua rau tuag taus, tab sis, nyob ntawm tus yam ntxwv ntawm tus neeg, txawm tias 50 ml yuav txaus rau tus neeg kom tuag sai.
Ethylene glycol lom tshwm sim thaum noj tshuaj. Los ntawm thawj feeb, nws pib rhuav tshem cov ntaub so ntswg thiab tib neeg lub hlwb, lub paj hlwb, ob lub raum thiab lwm yam kabmob. Kev sib sau ntawm ethylene glycol cov khoom hauv lub siab ua rau muaj kev cuam tshuam ntawm ntau yam ntawm nws cov haujlwm. Raws li cov tshuaj forensic, ethylene glycol lom ua rau muaj kev ua txhaum ntawm tag nrho cov txheej txheem metabolic hauv lub cev, suav nrog cov txheej txheem oxidative, synthesis ntawm cov protein los ntawm cov amino acids, kev hloov pauv hauv acidity ntawm ib puag ncig hauv plab, uas ua rau lub cev tsis muaj zog. Kev txiav txim ntawm cov tshuaj tiv thaiv tseem ceeb accelerators - enzymes.
Cov tsos mob tseem ceeb
Tom qab ib tug neegnoj cov tshuaj no los yog koob tshuaj ethylene glycol, cov tsos mob ntawm lom pib tshwm sim tom qab 2-3 teev los yog txawm tom qab 12 teev. Hauv qhov no, tus neeg yuav tuag, tsis nco qab, uas yog ib qho ntawm cov tsos mob ntawm kev lom.
Tom qab ob peb teev, tus neeg raug tsim txom pom cov cim hauv qab no ntawm ethylene glycol lom:
- tshwm sim ntawm cov leeg pob txha hauv lub cev;
- tshwm sim ntawm kev hnov qab;
- ib nrab lossis tsis hnov lus tag;
- coma xeev.
Ntawm no, lub hlwb o tuaj, uas ua rau kom tuag sai.
Tshuaj lom severity level
Nyob ntawm tus nqi ntawm ethylene glycol uas tau nkag mus rau hauv lub cev, qee yam kev phom sij tshwm sim hauv nws. Feem ntau, muaj peb hom kev lom:
- Kev kawm me me yog qhov tshwm sim ntawm kiv taub hau, qhov tsis muaj zog ntawm lub cev, xeev siab thiab mob nraub qaum.
- Qhov nruab nrab qib qhia tau hais tias nws tus kheej twb nyob rau hauv qhov nyuaj ntawm kev ywj pheej txav ntawm tus neeg raug tsim txom, kev ua haujlwm tsis pom kev, ib feem tsis nco qab.
- Kev kawm hnyav ua rau ua tiav kev tsis nco qab, tsis muaj zog ntawm cov mem tes, qhov pom ntawm convulsions thiab muaj feem ntau ntawm kev tuag sai.
Kev txhim kho tshuaj lom
Nyob ntawm cov tshuaj lom uas tau nkag mus rau hauv lub cev, thiab ntawm cov yam ntxwv ntawm tus kheej metabolism, cov txheej txheem hauv qab no tshwm sim:
- Ntau koob tshuaj ntau, yog tias tus neeg tsis tuag hauv thawj 24 teev, nws tuag hauv ib qholub hlis vim tsim lub raum tsis ua haujlwm.
- Yog qhov tshuaj lom tsis tseem ceeb, tus neeg ntawd yuav nyob, tab sis nws yuav muaj cov kab mob ntev ntev ntawm daim siab thiab lub raum, nrog rau kev puas tsuaj rau lub hauv nruab nrab thiab lub paj hlwb. Piv txwv li, lub raum tso tawm ethylene glycol cov khoom nyob rau hauv daim ntawv ntawm crystals, uas thaum kawg ua rau cov pob zeb nyob rau hauv cov zis.
Txheeb cais qhia tias 50% ntawm cov neeg uas tau ethylene glycol lom lom tuag hauv thawj lub hlis.
Tsis yog lub raum tsis ua haujlwm tsuas yog tshwm sim thaum muaj tshuaj lom nrog cov tshuaj lom no, tab sis kuj ua txhaum kev ua haujlwm ntawm lub ntsws, mus txog rau lawv cov edema, thiab ua haujlwm tsis zoo hauv cov hlab plawv. Tag nrho cov txheej txheem no tsim nyob rau hauv 72 teev tom qab tshuaj lom. Lub plawv tsis ua hauj lwm tuaj yeem ua rau lub plawv tsis ua haujlwm ntev, uas yuav ua rau tus neeg tuag nyob rau 5-6 xyoo tom ntej.
Tshuaj lom los ntawm kev nqus pa
Ethylene glycol tuaj yeem ua rau muaj tshuaj lom ntawm tib neeg lub cev rau lwm txoj hauv kev: los ntawm kev nqus pa, thiab tseem nkag mus rau hauv qhov hws ntawm daim tawv nqaij. Qhov xwm txheej no tshwm sim hauv kev tsim tshuaj lom neeg ntawm cov khoom no.
Ethylene glycol vapor lom hauv cov neeg cuam tshuam nrog nws cov khoom tsim ua rau cov txiaj ntsig hauv qab no:
- kab mob ntawm lub paj hlwb autonomic tsim;
- txo qis kev ua haujlwm tseem ceeb ntawm txhua lub cev, cov leeg tsis muaj zog, qaug zog thiab tsaug zog, qee zaumkev tsis nco qab yuav tshwm sim;
- hloov pauv hauv cov ntshav muaj tshwm sim, tshwj xeeb, cov leukocytes hauv nws txo qis, thiab cov qe ntshav liab poob lawv lub peev xwm los hloov cov pa oxygen;
- pom teeb meem tshwm sim, qhov muag ua kom qhuav, kab mob thiab lwm yam kab mob ntawm lub qhov muag;
- teeb meem nrog rau txoj kev ua pa (bronchitis, laryngitis thiab lwm yam) tshwm sim thiab phem dua;
- cuam tshuam hauv plab hnyuv, ua rau xeev siab, ntuav thiab mob plab hnyav.
Yog tias ib tug neeg muaj ob peb yam ntawm cov tsos mob ntawm ethylene glycol lom, lawv yuav tsum tau mus ntsib kws kho mob tam sim ntawd, vim tias kev noj qab haus huv muaj feem cuam tshuam. Tsis tas li ntawd, rau qhov "kev puas tsuaj" no, cov tub ceev xwm yuav tsum them nyiaj ntau rau lawv cov neeg ua haujlwm.
Diagnostics
Yog tias ib tug neeg, tom qab noj cov cawv, uas tau los ntawm cov kua hauv lub tsheb tsis khov, muaj kev hnov lus, convulsive leeg nqaij, xeev siab thiab ntuav, ces nws yuav tsum tau coj mus rau tsev kho mob sai, vim tias cov txheej txheem tsis tu ncua yuav tshwm sim. Cov paib (tsev kho mob) ntawm lom ethylene glycol.
Tus kws kho mob ua ntej ntawm tag nrho cov saib xyuas cov kev hloov pauv sab nraud hauv qab no:
- puas qhov tuab ntawm cov leeg ntawm retina nce thiab ua rau lub paj hlwb ci ntsa iab;
- yog tsis muaj tub kawm ntawv cov tshuaj tiv thaiv rau lub teeb;
- yog tus neeg raug tsim txom tsis nco qab;
- txawm qhov ua pa nce ntxiv, txawm tias hawb pob tshwm;
- Puas lub plawv dhia qeeb thiab lub plawv tsis muaj zog.
Yog tias tus kws kho mob tau txais cov lus teb zoo rau cov lus nug saum toj no thaum lub sijhawm kuaj, ces qhov mob ethylene glycol lom tshwm sim.
Ntxiv rau kev kuaj xyuas sab nraud, kev kuaj ntshav rau cov ntsiab lus ntawm cov piam thaj, ethanol thiab lwm yam tshuaj lom neeg kuj yuav tsum tau. Kev kuaj ntshav yog npaj kom paub meej qhov kev kuaj mob, vim tias muaj ntau cov tsos mob sab nraud ntawm ethylene glycol lom thiab, piv txwv li, formic cawv zoo sib xws.
Kev kho mob
Txhawm rau txhawm rau tshem tawm cov tshuaj lom ntawm lub cev, cov tshuaj diuretics tau muab rau cov neeg raug tsim txom. Cov tshuaj zoo tshaj plaws uas ua rau kom tshem tawm cov kua dej ntawm lub cev yog txiv lws suav, dib thiab blueberry kua txiv, nrog rau cov txiv hmab txiv ntoo. Tsis tas li ntawd, tus neeg mob tau qhia kom haus dej kom ntau.
Thaum qhov kev kuaj pom tseeb raug tsim, kev kho rau ethylene glycol lom yog siv cov txheej txheem hemodialysis rau cov neeg raug tsim txom. Cov txheej txheem no tso cai rau koj tshem tawm cov khoom lwj ntawm cov tshuaj lom ntawm lub raum, thiab tseem yog ib qho kev tiv thaiv tsim nyog rau cov hlab ntsha thiab cov hlab plawv.
Ethanol yog cov tshuaj tiv thaiv zoo tshaj plaws
Txawm li cas los xij nws yuav hnov zoo li txawv txawv, tab sis cov tshuaj tiv thaiv zoo tshaj plaws rau ethylene glycol lom yog ethyl cawv, uas tau muab rau tus neeg mob nrog qhov kev kuaj mob ntawm tus nqi ntawm 0.1 litre ib lub cev hnyav ntawm 60 kg. Kev kho mob nrog cawv txuas ntxiv rau 5-6 hnub.
Lub tswv yim tom qab siv cov tshuaj tua kab mob no yog tias nws muaj cov tshuaj zoo sib xws rau ethylene glycol, tab sis nws tsis yoglom lom. Kev noj haus cawv pab tshem tawm cov khoom ntawm cov tshuaj lom vim muaj kev hloov pauv hauv lub cev.
Nco ntsoov tias thaum lub sijhawm ua haujlwm hemodialysis, qib ntawm ethanol hauv cov ntshav ntawm tus neeg raug tsim txom tau khaws cia siab.
Kev pab ib zaug
Nws tsis yog ib txwm ua tau kom tus neeg raug mob mus rau tsev kho mob sai. Hauv cov xwm txheej zoo li no, nws yuav tsum tau ua tus kheej los ntsuas qhov tsim nyog thiab muab kev pab thawj zaug. Cov dej num hauv qab no ua tau zoo tshaj plaws:
- Yuav tsum ntuav ntuav thiab ntxuav lub plab nrog dej huv.
- Vim hais tias ethylene glycol nce acidity hauv lub plab, tus neeg raug tsim txom yuav tsum tau muab rau haus ib qho kev daws ntawm baking soda ntawm cov concentration kiag li.
- Thawj teev tom qab kev lom, kev noj cov tshuaj sorbent tuaj yeem nqus tau cov tshuaj lom ntau ntau. Qhov nrov tshaj plaws yog activated carbon. Kom ua tau zoo dua, nws raug pom zoo kom muab tsawg kawg ib ntsiav tshuaj ntawm 10 kg ntawm lub cev hnyav.
- Kev qhia cov piam thaj rau hauv cov ntshav yog lwm qhov kev ntsuas uas tuaj yeem txo tus neeg mob. Yog tias cov piam thaj hauv cov ntshav tsis muaj, ces koj tuaj yeem muab khoom qab zib rau tus neeg noj.
- Tus neeg mob yuav tsum tau so kom tiav thiab yuav tsum tau ua kom sov, piv txwv li los ntawm kev npog nrog daim pam sov lossis siv lub ntsuas kub kub.
