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挥发性物质急性中毒的诊断与治疗

Diagnosis and treatment of acute poisoning with volatile substances.

作者信息

Meredith T J, Ruprah M, Liddle A, Flanagan R J

机构信息

Poisons Unit, Guy's Hospital, London, UK.

出版信息

Hum Toxicol. 1989 Jul;8(4):277-286. doi: 10.1177/096032718900800405.

DOI:10.1177/096032718900800405
PMID:2777267
Abstract
  1. The acute toxicity of many volatile compounds is similar, being more related to physical properties than to chemical structure. 2. Volatile substance abusers experiences euphoria and disinhibition but this may be followed by nausea and vomiting, dizziness, coughing and increased salivation; cardiac arrhythmias, convulsions, coma and death occur in severe cases. 3. Laboratory analysis of blood and urine samples collected up to 24 h post-exposure may be helpful if the diagnosis of volatile substance abuse is in doubt. 4. There is only a weak correlation between blood toluene and 1,1,1-trichloroethane concentrations and the clinical features of toxicity, possibly because of rapid initial tissue distribution and elimination. 5. Recovery normally occurs quickly once exposure has ceased but support for respiratory, renal or hepatic failure may be needed as well as treatment for cardiac arrhythmias. Therapy with intravenous acetylcysteine should be considered in cases of acute carbon tetrachloride poisoning.
摘要
  1. 许多挥发性化合物的急性毒性相似,更多地与物理性质而非化学结构有关。2. 挥发性物质滥用者会体验到欣快感和行为不受抑制,但随后可能会出现恶心、呕吐、头晕、咳嗽和唾液分泌增加;严重时会发生心律失常、惊厥、昏迷甚至死亡。3. 如果对挥发性物质滥用的诊断存在疑问,对暴露后24小时内采集的血液和尿液样本进行实验室分析可能会有所帮助。4. 血液中甲苯和1,1,1 - 三氯乙烷浓度与毒性临床特征之间的相关性较弱,这可能是由于最初组织快速分布和清除所致。5. 一旦停止接触,通常会迅速恢复,但可能需要对呼吸、肾脏或肝脏衰竭进行支持治疗以及对心律失常进行治疗。对于急性四氯化碳中毒病例,应考虑静脉注射乙酰半胱氨酸进行治疗。

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Diagnosis and treatment of acute poisoning with volatile substances.挥发性物质急性中毒的诊断与治疗
Hum Toxicol. 1989 Jul;8(4):277-286. doi: 10.1177/096032718900800405.
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An introduction to the clinical toxicology of volatile substances.挥发性物质临床毒理学概论
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[Gas chromatographic detection of chloroform, carbon tetrachloride, dichloroethane, trichloroethane and chloral hydrate in biological material].[气相色谱法检测生物材料中的氯仿、四氯化碳、二氯乙烷、三氯乙烷和水合氯醛]
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The role of the laboratory in the investigation of solvent abuse.实验室在溶剂滥用调查中的作用。
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Acute carbon tetrachloride poisoning in 19 patients: implications for diagnosis and treatment.19例急性四氯化碳中毒患者:对诊断和治疗的启示
Lancet. 1985 May 4;1(8436):1027-9. doi: 10.1016/s0140-6736(85)91624-1.
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Fatal inhalation of 1,1,1-trichloroethane.1,1,1-三氯乙烷致死性吸入
Forensic Sci Int. 1997 Jun 6;87(2):161-5. doi: 10.1016/s0379-0738(97)00040-6.
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Chronic non-neurological toxicity from volatile substance abuse.挥发性物质滥用所致慢性非神经毒性
Hum Toxicol. 1989 Jul;8(4):301-6. doi: 10.1177/096032718900800408.
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The use of automated headspace gas chromatography for determination of 1,1,1-trichloroethane in rat blood and brain tissue.
Int J Environ Anal Chem. 1982 Nov;12(3-4):233-9. doi: 10.1080/03067318208078330.
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[Identification and quantitative determination of chlorinated++ solvents after solid phase microextraction. Applications in hospital toxicology].[固相微萃取后氯化++溶剂的鉴定与定量测定。在医院毒理学中的应用]
Acta Clin Belg. 1999;53 Suppl 1:89-93.

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