Ukulimala kwe-Caustic kungenzeka uma umkhiqizo owomile noma wamakhemikhali uphonywa noma ugonywa, noma ngenhloso noma ngengozi. Izingane ezineminyaka engama-1 kuya kwengu-3 ubudala ziyakwazi ukufaka ingozi ngokweqile imikhiqizo ejwayelekile ye-caustic. Noma kunjalo, izingane ezingaphansi kweminyaka engu-5 zimelela cishe ingxenye yesigameko esibikiwe. Abantu abadala abanomonakalo wokungenisa umkhuhlane bavame ukuhlobana nokuzivelela emsebenzini noma ukuzibulala.
Ukulimala kwe-Caustic ngokuvamile kuvela endleleni yakho yokuphefumula (impumulo, umlomo, umphimbo noma i-pharynx, nebhokisi lezwi noma i-larynx) kanye nomgudu wokugaya ukudla okuphezulu (isisu, isisu, ne-duodenum). Inengozi yokulimala ikhuphuka ehlobene nokuthi i-acidic noma eyisisekelo izinga le-pH (okungenzeka i-hydrogen) ingumkhiqizo. I-pH engathathi hlangothi ingu-7. I-pH engezansi iphansi, umkhiqizo usebenza kakhulu, kuyilapho i-pH ephakeme isisekelo esengeziwe. Imikhiqizo yamakhemikhali ibandakanyeka ngamaphesenti angama-70 amacala okugaya i-caustic; Amacala asele amelwa kakhulu ngokufaka imikhiqizo e-acidic.
I-Caustic vs. Ukulimala Okulimazayo
Ngokuvamile, amagama asetshenziselwa ukulimaza asetshenziswa ngokungafani. Noma kunjalo, yiwo amagama angasetshenziswa ukuhlukanisa uhlobo lomkhiqizo wamakhemikhali owabangela ukulimala. I-Caustic ibhekisela kumikhiqizo yamakhemikhali eqinile eyisisekelo noma i-alkaline. Ukulimaza ngakolunye uhlangothi kubhekisela kumikhiqizo yamakhemikhali enamandla kakhulu.
Ama-caustic and corrosive agents angase abe nobuthi, kodwa akuwona wonke ama-caustic and corrosive agents ayenobuthi. Ama-poisoni athatha isikhathi sokudala umonakalo, kanti ama-caustic and corrosive agents angalimaza izicubu zomzimba ngokushesha lapho uxhumane. Ama-poisoni avame futhi angabangeli umonakalo ongakodwa, kodwa kunalokho kubangele imiphumela emihle emzimbeni wakho.
Njengoba kunjalo nezincwadi eziningi, sizobhekisela kuma-caustic kanye nama-corrosive agents njenge "caustic."
Izimpawu
Kunezinhlobo eziningi zezimpawu ezingase zilandele ukungena kwamakhemikhali amancane. Lokhu kungenxa ye-pH ehlukahlukene yemikhiqizo, ubuningi bokudla, nesikhathi sokuxhumana esinomzimba womzimba. Ngokuvamile, uma ungenayo izimpawu, ungase ungabi nokulimala kanzima. Noma kunjalo, lokhu akusho ukuthi awuzange ulimale futhi ulandele udokotela kungase kudingeke. Uma uhlangabezana nezimpawu ezingu-3 noma ngaphezulu, ukulimala kanzima ku-esophagus yakho kungaboniswa. Ungase ubone izibonakaliso ngokushesha lapho upha, noma ungase ubone izimpawu ezimbalwa amahora kamuva. Amapulazi athambekele ekuboniseni izimpawu kamuva kunomjovo we-caustics wamanzi. Izimpawu ongazithola zifaka:
- Ukuvota - uphawu oluvame kakhulu
- I-Dysphagia (ubunzima bokugwinya) - 2 ngivamile kakhulu
- Odynophagia (ukugwinya okubuhlungu)
- Ukuphelelwa umoya
- I-Tachycardia (isilinganiso senhliziyo esisheshayo)
- Ubuhlungu besifuba
- Ubuhlungu besisu
- Ukukhiqizwa kwemali yokwanda
Izinkinga ezinzima ezihlobene nokulimala kwe-caustic zingenzeka futhi kufaka phakathi ukukhubazeka komzimba futhi kungafaka ukufa. Ngenxa yobungozi obunobungozi, kufanele uhlale uthintana noPheyili Control ku (800) 222-1222 .
Imikhiqizo okufanele uyigweme
Imikhiqizo enamakhemikhali
Imikhiqizo eminingi yokuhlanza indlu i-alkali noma amakhemikhali ayisisekelo. Imikhiqizo yasendlini engase ibangele ukulimala kwe-caustic uma ingenwa ku-pH uhla lwe-11 ukuya ku-14, kodwa ngisho nemikhiqizo ene-pH u-8-10 ingabangela ukulimala okuthile. Imikhiqizo yamakhemikhali okufanele ugcine ukufinyeleleka kwezingane ihlanganisa:
- Ukuhlanza izihlanzi: i-Liquid Plumr kanye noDiquid Drano
- Abahlanzi be-oven: I-Easy-Off
- Izinwele zokuphumula: Revlon Creme Relaxer
- I-Ammonia ehlanzekile: i-Lysol Yonke Inhloso, i-Windex
- Ama-detergents wokuhlanza: I-Tide, i-Purex
Isithako esivamile ekuhlanzeni ama-sodium hydroxyde. I-Lye ne-soda caustic yilawo amanye ama-sodium hydroxide, kodwa futhi ingasetshenziswa njenge-potassium hydroxide.
I-hydrodium i-sodium iyinhlangano yokuhlanza eshibhile futhi enamandla.
Ukulimala kwesisu kuvame ukuba nzima kakhulu ngemikhiqizo ye-alkaline ngoba isisu sakho se-acid singakwazi ukunciphisa noma ukulinganisela amanye ama-alkali. Emlonyeni nasendlini, noma kunjalo, imikhiqizo ye-alkaline iqala ukulimaza ngokushesha izicubu kuze kube yilapho umthamo ophakathi kwamathisipulini ungenelela ngokwanele umkhiqizo we-caustic. Ukulimala ngenxa yemikhiqizo ye-alkaline kubizwa ngokuthi i- necrosis ye-liquefactive , okusho ukuthi umonakalo obulala amangqamuzana uphenduka ezinye zezicubu zibe ifomu eligciniwe.
Imikhiqizo emihle
Ukulimala okunomsoco kwenzeka kaningi kangako ngoba imikhiqizo ye-acidium ngokuvamile ibangela ubuhlungu uma emlonyeni. Imikhiqizo emihle ibuye ibe nomzimba omncane, okwenza kube nomonakalo ombalwa kakhulu kulesi sifo njengoba uketshezi lufika ngokushesha esiswini. Isisu esingaphansi (esaziwa nangokuthi i-antrum) kuyisici esivamile sokulimala okukhulu okwenzeka njengoba ukugeleza kwezinto eziphilayo kumile lapha. Ukudla esiswini kungasiza ukunciphisa umonakalo okwenzeka njengoba ukudla kungamnika i-asidi. Imikhiqizo emihle kakhulu nge-pH ngaphansi kwezingu-2 yingozi kakhulu. Imikhiqizo okufanele uhlale kude nezingane ihlanganisa:
- Amanzi okuhlanza izitsha zangasese: Lysol, Kaboom
- Abahlanza amanzi okubhukuda
- Ama-removing Rust: i-CLR (i-Calcium, i-Lime, i-Rust), i- Evapo-Rust
Imikhiqizo emihle idala umonakalo obizwa ngokuthi i- necrosis eyigugu , eyenza ama-clots kanye nezicubu ezibomvu endaweni yesimonakalo. Kucatshangwa ukuthi ngenxa yesikhala esinqamule futhi lokho okuncane okuvame ukugonywa ngenxa yobuhlungu obuyingozi emlonyeni ukuthi umonakalo omkhulu owenziwe ngokungenisa ama-acids uma kuqhathaniswa ne-alkali.
Kuthiwani Nge-Bleach?
I-Bleach iyinhlangano ye-alkaline caustic, kodwa-ke, ivame ukungaqondi kahle njengoba kubangela ukulimala okukhulu. I-Bleach ivame ukudayiswa njengomkhiqizo we-pH ongathathi hlangothi (okusho okuzungeze i-pH ye-7). Ngenxa yokungathathi hlangothi kwe-pH, empeleni i-bleach ibhekwa njengokungathi iyisimanga kunomuthi we-caustic. Ngokuvamile, ukungenisa kwe-bleach kudinga ukubonwa okusheshayo kwezimpawu ezibalwe ngenhla. Ngenkathi ihlukaniswe kuphela njengenkinga ephikisayo, yokuphefumula kanye neminye imiphumela emibi engase yenzeke uma kwenzeka inani elanele noma inhalation livela.
Ubunzima bokulimala
Ubukhulu bokulimala kwe-caustic kulinganiswa ngendlela efanayo nesistimu efanayo njengokushisa. Kodwa-ke, abanye odokotela banganezela ibanga lesi-4 ngenxa yokulimala kakhudlwana.
- Ukuvuvukala (i-edema) nokubomvu (i-hyperemia)
- Ukuqothula
- 2a - izilonda ezingekho emzimbeni kanye nokukhipha izingqimba ezimhlophe
- 2b - izilonda ezijulile kanye nokuphuma kwegazi okudlulela ngaphesheya kwendawo yokuxhumana
- Izicubu ezonakalisiwe
- 3a - inamba encane yezindawo ezihlakazekile lapho izicubu zishonile
- 3b - izindawo ezinde lapho izicubu zifile khona
- I-Perforation - izicubu eziphukile noma eziqhekekile eziholela kwezinye izindawo zomzimba
Izinga lokulimala lingathathwa ngokubona indawo endaweni yenqubo yokugcina i-EGD. Imiphumela emihle iyenzeka ukuba yenzeke uma uke wabhekana nokulimala kwebanga lesibili noma kwebanga lesibili; ukutakula ngokugcwele kwenzeka kaningi. Uma unobungozi bebanga lesi-2b noma ibanga lesi-3a, cishe uzoba nokuvinjelwa okungapheli ( isiteji ) kwisayithi elimele. Ibanga lesi-3b noma lesi-4 linomngcipheko omkhulu wokubangela ukufa; cishe amaphesenti angu-65. Incazelo eqhubekayo enikezwe ngaphansi kokuPhathwa kwe-Caustic Ingestion .
Ukwelapha
- Ungadli amalahle, ngoba awubopheli ezintweni ezithintekayo
- Ungadli ukuhlanza; engozini yokuchayeka okwesibili kwesimiso, umoya ohamba phambili, umlomo, nephunga kuya emthonjeni we-caustic
Ngemuva kokuqaphela ukuthi ukungena komuthi we-caustic (noma okubangelwa yi-caustic) kwenzeka, kufanele uhlale uxhumane noPhethon Control. Ngokuvamile kubhekwa njengokuphephile ukuphuza amanzi noma ubisi emva kokungenisa noma into e-alkali noma i-acidic ukuze kuhlanjululwe into. Kodwa-ke, kufanele ugweme ukuphuza ngokweqile ngokugwema ama-milliliters angaphezu kuka-15 oketshezi kuwo wonke ama-kilogram (2.2 amakhilogremu) wesisindo somzimba.
Akungabazeki ukuthi ukukhathazeka okuphumela uma usuqaphela okwenzekile. Ukwazi ukuthi yini ongayilindela kungasiza ekunciphiseni ukwesaba futhi kukushukumisele ukuba uthathe isenzo. Yazi ukuthi konke okwenzekayo kwenziwa ngesizathu-ukukusiza ukuba ululame futhi uqhubeke uphila kahle. Ukulawula Ubuthi kuzokusiza ukuthi unqume noma ngabe udinga yini ukuya esibhedlela. Kodwa uma ukuphefumula kubonakala kunzima, kufanele uhlale ubiza i-EMS - Emergency Medical Services (911 e-United States), futhi ucele usizo lwezokwelapha ngokushesha. Uma ikhono lakho lokugcina umoya wakho liwukukhathazeka, i-EMS noma udokotela ophuthumayo (ED) udokotela uzobeka ithubhu lokuphefumulela (intubation).
Lapho efika emnyangweni ophuthumayo, isidingo sokuphela kwe-endoscopy (EGD) sizohlolwa. Ngokuvamile, i-EGD izokwenziwa uma ukuvezwa kwenzeka phakathi kwamahora angu-12 no-48. Uma ukuhlolwa kwenziwa kusenesikhathi, izinga lomonakalo lingase likwazi ukubonakala ngokugcwele. Ngemuva kwamahora angu-48 futhi usengozini yokulimala ngokulimaza i-esophagus ngobubanzi.
Ngokuya ngobukhulu bokulimala, ungase ukhululwe, uhlonishwe amahora angaba ngu-24, noma uvunyelwe esibhedlela ukuze uqhubeke nokuphathwa kokulimala kwakho. Uma ukulimala kwakho kunzima ngokwanele, ithubhu yokudla ingafakwa ngesikhathi se-EGD ukugwema ukulimala okuqhubekayo nokubekwa "okuyimpumputhe". Ungase futhi ube ne-tube yokudla efakwe kamuva ngaphansi kwe- fluoroscopy . Ama-antibiotic nawo angase aqalwe ngokuya kwezinga lokulimala kanye nengozi yokutheleleka. I-Okwamanje ayiyona inkinga enamandla ye-steroids, noma kunjalo, ungayibona ibhalwe kwezinye izilungiselelo.
Uma uhlangabezane nokulimala kanzima noma ungazange ube ne-EGD eyenziwe ngaphambi kwamahora angu-48, cishe uzobe nesifundo sokugwinya se-barium ukuze uhlole noma yikuphi ukuvinjelwa (izigaluko) noma ukuboshwa kwe-linings (i-perforation). Uma kutholakala izintambo, ngokuvamile zizokwenza i- dilational esheshisayo . Uma kudingeka ukulandelela, ngokuvamile ungalindela ukuhlolwa okuzokwenziwa cishe emavikini amathathu kamuva.
Kulimala kakhudlwana, ukuhlinzekwa kabusha kokwakhiwa noma ukususwa kwengxenye yesifo (esophagectomy) kungadingeka.
> Imithombo:
> Bird, JH, Kumar, S, Paul, C & Ramsden, JD. (2016). Impikiswano ekulawulweni kokulimala kokudla kokudla: ukubuyekezwa okusekelwe ebufakazini. I-Clin Otolaryngol. i-doi: 10.1111 / coa.12819.
> Schoem, SR, Rosbe, KW & Bearelly S. (2015). I-Cummings i-Otolaryngology: Amaqembu angaphandle angama-Foreign and Caustic Ingestions. 6 th . Elsevier
> Triadafilopoulos, G. (2016). Ukulimala kwamaphutha kubantu abadala. Kufinyelelwe ngo-1/11/2017 kusuka ku-UpToDate (Ukubhaliselwe Kudingeka).
> Weigert, A. (2005). Ukungenisa kwe-Caustic ezinganeni. Ukuqhubeka Nokunakekelwa Kwezinhlungu Zokunakekela U-Anaesth. 5 (1): 5-8. doi: 10.1093 / bjaceaccp / mki007
> I-Wightman RS, i-Read KB, i- Hoffman RS. (2016). Ukuphathwa Okusekelwe Ebufakazi Bokukhangisa Kwama-Caustic Emnyangweni Wezimo Eziphuthumayo. Emerg Med Pract. 18 (5), 1-17