驰放气烧伤的临床特点

驰放气是生产化肥过程中所产生的尾气。主要成分为氢气、甲烷和少量的氨气。由干含有可燃性气体，可作为化肥厂职工家庭生活燃气。由于种种原因造成气体泄漏，一旦密闭空间内驰放气浓度达到临界浓度时，遇明火即可导致燃烧爆炸，对人体造成损伤。1临床资料我院从1982年7月至1995年10月共收治驰放气烧伤168例，男96例，女72例：年龄15～78岁：面部烧伤80例，手烧伤75例，会阴部烧伤27例，吸入性损伤23例，合并化学中毒5例，其中一氧化碳中毒3例，氨中毒1例，氮氧化物中毒1例。烧伤面积10％以下68例，11％～30％48例，31％～50％44例，50％以…     

急性氨中毒15例临床分析

1995年5月4日下午3时,某市冷冻厂液氨管道突然爆裂,液氨泄漏,在车间工作的15人吸入氨气中毒,于中毒后2～3ｈ内先后入我院抢救,均治愈出院。现报告如下。1　临床资料11　一般资料　15例均为女性,年龄18～35岁,既往健康。按国家“急性氨中毒　　表1　15例急性氨中毒主要临床表现例中毒程度例数皮肤灼伤角膜溃疡上呼吸道损伤肺部音喉头水肿肺水肿气道粘膜坏死脱落发热38～40℃霉菌感染轻度3——33—————中度5—455—————重度7377717353合计15311151517353　　上呼吸道损伤为鼻、咽、喉损伤诊断标准”分级,轻度中毒3例,中度中毒5例,重…     

硫酸二甲酯与氨混合气体吸入性损伤13例临床分析

硫酸二甲酯与氨混合气体吸入性损伤１３例临床分析宋阳生，王莹，张宪华，金永才急性硫酸二甲酯（ＤＭＳ）和急性氨（ＮＨ３）中毒的临床病例报告甚多，但ＤＭＳ气体与氨气混合性吸入性损伤比单一毒物对人体的损伤更为严重，我们就一起群体性的以ＤＭ５为主伴有ＮＨ３的气...     

氨中毒致心肌损伤6例报告

急性氨中毒是吸入氨气后引起的以呼吸系统急性损害为主要表现的中毒性疾病 ,严重者常引起心脏、肝脏等脏器的损伤 ,现将我院收治的氨中毒致心肌损伤 6例病例报告如下。1　临床资料1 1　一般资料　男 2例 ,女 4例 ,年龄 18～ 3 5岁 ,平均 2 6岁 ,患者均为工厂工人。1 2　中毒原因　 6例均为化工生产过程中氨气泄漏所致 ,经呼吸道过量吸入而中毒。1 3　诊断分级　按国家“职业性急性氨中毒诊断标准”[1] 分级 ,均为重度氨中毒。1 4　主要临床表现及实验室检查　接触氨后立即发病 ,其中 2例昏迷 ,另外 4例均有剧烈咳嗽、咯大量粉红色泡沫痰、胸…     

硫酸二甲酯与氨混合气体吸入性损伤13例临床分析

急性硫酸二甲酯(DMS)和急性氨(NH_3)中毒的临床病例报告甚多,但DMS气体与氨气混合性吸入性损伤比单一毒物对人体的损伤更为严重,我们就一起群体性的以DMS为主体有NH_3的气雾混合性吸入性损伤的病例进行总结,将其临床特点、现场处理,诊断要点以及急性处理的经验教训分析如下。     

急性氨中毒14例急救与护理体会

急性氨中毒为短时间内吸入高浓度氨气或接触液氨所致。群体性氨气中毒在我国相当少见,但中毒者病残率及死亡率高。能否及时、恰当救治,对患者预后至关重要,而护理工作常是抢救成功与否的重要环节。现将我院1995年4月1次收治的14例氨中毒急救情况与护理体会总结如下。1 临床资料1.1 一般资料 14例均系我市某冷冻厂氨气管道破裂所致中毒患者。其中男5例,女9例,年龄20～40岁,平均27.6岁。中毒后就诊时间30分～3小时,平均1.6小时。     

铬中毒人体脏器损伤探讨

目的探讨铬中毒对机体损伤,根据临床病例分析铬中毒脏器损伤,以期减少铬中毒发生率,寻求及时有效的治疗方案,同时为职业铬中毒有关其他脏器损伤情况积累临床资料。方法对我院1986年9月~2011年11月收治的14例铬中毒患者进行临床观察。外用5%硫代硫酸钠溶液,根据病情应用二巯基丙磺酸钠或硫代硫酸钠治疗。结论铬中毒可导致皮肤、脏器损伤。     

34例急性氨气中毒的临床特点分析

收集北京朝阳医院2003—2015年收治的34例急性氨气中毒患者的临床资料,对其发病情况、临床症状和体征、实验室检查指标和急救治疗措施及转归情况进行回顾性分析。     

急性吸入性氨中毒的氧疗和气道管理

目的:探讨急性吸入性氨中毒的临床特点和急救措施.方法:回顾总结32例急性吸入性氨中毒临床资料.结果:经有效氧疗和气道管理,全部痊愈出院.所有患者未行高压氧疗.无气道穿孔、肺不张、气管狭窄发生.结论:急性吸入性氨中毒患者特点是气道损伤创面广泛、可侵及粘膜下层、渗出多、不易结痂修复,故气道分泌物多,病程长.处理的重点是保持呼吸道通畅,及早实施有效氧疗.     

儿童群体急性氨气中毒43例报告

成人急性氨中毒病例在国内外有不少报道,但儿童群体急性氨中毒报告甚少。我院于1995年6月收治了因氨气钢瓶爆炸造成43例儿童急性氨气中毒,现报告如下: 1 中毒经过 1995年6月,我市某冰糕厂发生氨气钢瓶突然爆炸事故,距离事故现场约20m左右的某幼儿园43名儿童正值午休,大量的氨气顺风由门窗飘入,致使全部儿童吸入氨气2～10分钟,这期间,在幼儿园老师的组织抢救下,43名儿童全部脱离现场,随即送往我院就诊。 2 临床表现 43例患儿中男29例,女14例,年龄2岁半至7岁。43例全部出现流泪、呛咳、恶心、头晕。伴有非喷射性呕吐12例;剧烈咳嗽、声音嘶哑15例;呼吸     

Hair chromium as an index of chromium exposure of tannery workers

The use of hair chromium (Cr) concentrations as an index of Cr exposure of tannery workers was investigated. As has been shown earlier, Cr from Cr III compounds used in the leather tanning industry is absorbed because concentrations of Cr in serum and urine of tannery workers are significantly increased compared with corresponding concentrations for unexposed controls. Hair samples were collected from 71 male tannery workers from four southern Ontario tanneries and from 53 male controls not exposed to Cr in the workplace. Subjects were matched for age, race, and socioeconomic status. Hair samples were washed, ashed in a low temperature asher, and analysed by flameless atomic absorption. The median hair Cr concentrations for the tannery workers (551 ng/g) was significantly higher (p = 0.0001) than for the controls (123 ng/g). For the tannery workers, hair Cr concentrations were positively and significantly correlated with serum Cr (r = 0.52, p less than 0.01) and with the preshift and postshift urinary Cr/creatinine ratios (r = 0.43, p less than 0.01; r = 0.64, p less than 0.01, respectively). These data indicate that trivalent Cr absorbed from leather tanning compounds results in raised concentrations of Cr in hair and that hair Cr concentrations may be used as an index of industrial Cr exposure.     

Effect of chromium supplementation on hair chromium concentration and diabetic status

Thirty-nine diabetic and 39 non-diabetic subjects matched for age and sex were given torula yeast (placebo) or brewer's yeast (68 μg chromium/day) in a double blind experiment. Hair chromium concentration was determined on all subjects before and after the 90 day yeast supplementation period. An overnight fasting blood sample was drawn from all diabetic subjects before and after yeast supplementation. The blood was analyzed for glycosylated hemoglobin and for serum glucose, insulin, total cholesterol, HDL cholesterol, and triglycerides. Mean initial hair chromium concentration of the non-diabetic subjects was 383±75 ppb, which was greater than that of the diabetic subjects (317±74 ppb) (p<0.001). Hair chromium concentration increased 111±78 ppb in subjects who received high chromium yeast compared with 17±80 ppb in those who received the placebo (p<0.001). The amount of increase in hair chromium concentration was similar between non-diabetic and diabetic subjects who received the high chromium yeast (p<0.05). No significant effect of chromium supplementation occurred in diabetic subjects as measured by any of the blood parameters (p>0.05).     

铬及其化合物对雄(男)性生殖毒理学研究进展

铬为动物和人体内必需的微量元素，参与糖、蛋白质、核酸和脂肪的代谢，促进机体生长发育，也促进细胞的增殖和分裂。因此，适当剂量的铬对人体健康有利。但长期过量接触铬化合物对人体产生不良影响。铬及其化合物在许多工业生产中被广泛应用。经常暴露于铬化合物的工作场所有冶金、镀铬、不锈钢     

Hair chromium as an index of chromium exposure of tannery workers.

The use of hair chromium (Cr) concentrations as an index of Cr exposure of tannery workers was investigated. As has been shown earlier, Cr from Cr III compounds used in the leather tanning industry is absorbed because concentrations of Cr in serum and urine of tannery workers are significantly increased compared with corresponding concentrations for unexposed controls. Hair samples were collected from 71 male tannery workers from four southern Ontario tanneries and from 53 male controls not exposed to Cr in the workplace. Subjects were matched for age, race, and socioeconomic status. Hair samples were washed, ashed in a low temperature asher, and analysed by flameless atomic absorption. The median hair Cr concentrations for the tannery workers (551 ng/g) was significantly higher (p = 0.0001) than for the controls (123 ng/g). For the tannery workers, hair Cr concentrations were positively and significantly correlated with serum Cr (r = 0.52, p less than 0.01) and with the preshift and postshift urinary Cr/creatinine ratios (r = 0.43, p less than 0.01; r = 0.64, p less than 0.01, respectively). These data indicate that trivalent Cr absorbed from leather tanning compounds results in raised concentrations of Cr in hair and that hair Cr concentrations may be used as an index of industrial Cr exposure.     

Serum chromium of human subjects: effects of chromium supplementation and glucose

Seventy-six adult subjects, 48 males and 28 females, were given placebo or 200 micrograms Cr in the form of chromic chloride in a double-blind crossover study, with 3-month experimental periods, to determine basal serum Cr levels and the effects of Cr supplementation on serum Cr and related variables. Basal serum Cr determined by graphite furnace atomic absorption for all subjects was 0.13 +/- 0.02 ng/ml (mean +/- SEM), and increased significantly to 0.38 +/- 0.02 ng/ml following 3 months of Cr supplementation. There were no significant differences in the serum Cr values for males and females. Serum Cr 90 min following a glucose load (1 g per kg body wt) was not significantly different from fasting during either the placebo or Cr supplementation periods. These data demonstrate that serum Cr increased significantly following Cr supplementation and is a reflection of Cr intake, but serum Cr concentration, even that following a glucose load, does not appear to be a meaningful indicator of Cr status.     

Hair chromium concentration and chromium excretion in tannery workers.

Hair and urine samples were collected from 34 male tannery workers and from 12 normal adults. Eighteen of the workers dealt directly with chromium and the remaining 16 (controls) worked in the offices and kitchen of the same factory. All were found to be clinically healthy. Chromium was determined by flameless atomic absorption spectroscopy. When compared with normal adult values, urinary chromium concentration, Cr/Creatinine ratio, daily chromium excretion, and hair chromium, concentrations were significantly higher and urinary beta 2-microglobulin/Cre ratios significantly lower in both tannery workers and in controls. A significant negative correlation was found between urinary beta 2-microglobulin/Cre and Cr/Cre ratios of tannery workers and controls. A significant positive correlation was shown between hair chromium and urinary Cr/Cre values in all workers. No correlations between the duration of exposure to chromium and hair and urinary chromium values were found. Nevertheless, high values observed in workers with short exposures show that chromium is readily absorbed through the respiratory system.     

Placental transport of chromium

Since trivalent chromium (Cr+3) transport into certain tissues is rapid, the placental transport of injected high specific activity 51Cr+3 was studied in pregnant rats at days 17-20 of gestation. Three days after the intravenous injection of 51Cr+3, body retention of 51Cr was similar in pregnant and nonpregnant rats, but in the pregnant rats placentofetal uptake of 51Cr accounted for 25-30% of the 51Cr retention. The mean 51Cr content per placentofetal unit was 0.89 +/- 0.03% injected dose. Serum and tissue 51Cr contents per milliliter or gram in the pregnant rats were decreased by 50-80% except in uterus, which was unchanged. Tissue/serum 51Cr ratios were increased by 70-300% in the pregnant rats compared to the nonpregnant controls. These results indicate that the placentofetal unit is capable of extracting large amounts of Cr from the mother, and support the suggestion that maternal Cr is depleted during pregnancy. The data also suggest that body tissues may defend their Cr stores against Cr depletion by adaptive cellular Cr transport mechanisms.     

The biochemistry of chromium

Chromium has been known to be a micronutrient for mammals for four decades, but progress in elucidating the role of chromium has proceeded slowly. However, recent studies have shed light on a potential role of chromium in maintaining proper carbohydrate and lipid metabolism at a molecular level. The oligopeptide chromodulin binds chromic ions in response to an insulin-mediated chromic ion flux, and the metal-saturated oligopeptide can bind to an insulin-stimulated insulin receptor, activating the receptor's tyrosine kinase activity. Thus, chromodulin appears to play a role in an autoamplification mechanism in insulin signaling. The molecular agent responsible for transporting chromium from mobile pools to insulin-sensitive cells is probably the metal transport protein transferrin. Chromium from the popular dietary supplement chromium picolinate enters cells via a different mechanism. Release of chromium from chromium picolinate for use in cells requires reduction of the chromic center, a process that can lead potentially to the production of harmful hydroxyl radicals.