Inzakalo ye-Caustic ingenzeka xa umveliso owomileyo okanye umichiza uphonywa okanye ugonywa, mhlawumbi okanye ngengozi. Abantwana abaphakathi kweminyaka eli-1 ukuya kwe-3 ubudala banomdla wokungenisa ngokungekho mveliso iimveliso eziqhelekileyo ze-caustic. Nangona kunjalo, abantwana abangaphantsi kweminyaka engama-5 bamele malunga nesiqingatha seziganeko ezichaziweyo. Abantu abadala abanobungozi bokungcolisa i-caustic accredited are often related to their work or self-injury.
Ukulimala kwe-Caustic kubonakala kwindlela yakho yokuphefumula (impumlo, umlomo, umphimbo okanye i-pharynx, kunye nebhokisi yezwi okanye i-larynx) kunye nephepha eliphezulu lokutya (isisu, isisu, ne-duodenum). Inengozi yokulimala inyuselwa kwindlela ehambelana ngayo nokuba isisiseko okanye isiseko se-pH (ubunako be-hydrogen) yile mveliso. I-pH engathathi hlangothi i-7 . Ngaphantsi kwe-pH yile mveliso, xa i-pH ephezulu isisiseko. Iimveliso ze-alkaline zibandakanyeka ngamaphesenti angama-70 eengxaki zokungenisa i-caustic; Amatyala asele ayenziwa kakhulu ngokungenisa iimveliso ezicokisekileyo.
Caustic vs. Corrosive Injury
Ngokubanzi, zombini amagama asetshenziselwayo kunye neengcambu ziyasetyenziswa ngokungafaniyo. Nangona kunjalo, yimiqathango engasetyenziselwa ukwahlula uhlobo lwemveliso yamachiza eyenza ukulimala. I-Caustic ibhekisela kwimveliso yeekhemikhali ezinamandla ezisisiseko okanye i-alkaline. Ukuxhamla ngakwelinye icala kubhekisela kwimveliso yeekhemikhali enamandla kakhulu.
Iimpawu ezinobangela kunye nezobuhlungu zinokuthi zibe neetyhefu, nangona kunjalo akubona zonke izinto ezinobangela kunye nezobuhlungu ezinobungozi. Amathumba athatha ixesha lokudala umonakalo, kanti amanxeba angabonakaliyo kunye noobuhlungu angonakalisa izicubu zomzimba ngokukhawuleza. Iimvumba kaninzi azibangela ukuba umonakalo wendawo wodwa ungabangela ukuba kubekho umonakalo emzimbeni wakho.
Njengoko kunjalo nangona uninzi lweencwadi, siza kubhekisela kuzo zombini i-caustic ne-corrosive agents "njengengxaki."
Iimpawu
Kukho uluhlu olubanzi lweempawu ezingalandela ukungena kweekhemikhali ezinobangela. Oku kungenxa ye-pH eyahlukeneyo yemveliso, ubuninzi bokutya, kunye nexesha lokudibana kunye nezicubu zomzimba. Ngokuqhelekileyo, ukuba unayo impawu, awukwazi ukulimala kakhulu. Nangona kunjalo, oku akuthethi ukuba awuzange ufumane ukulimala kunye nokulandelelana nodokotela kunokusafuneka. Ukuba ufumana iimpawu ezi-3 okanye ngaphezulu, ukulimala kanzima kwisifo sakho kungaboniswa. Unokufumana iimpawu ngokukhawuleza ekungeneni, okanye unokufumana iimpawu eziliqela emva kweeyure. Amagqabi athambekele ekubonakaliseni iimpawu emva kokungena kwe-caustics yamanzi. Izibonakaliso onokuzifumana ziquka:
- Ukuvutha - uphawu oluqhelekileyo
- I-Dysphagia (ubunzima bokugwinya) - 2 ixhaphake kakhulu
- Odynophagia (ukugwinya okubuhlungu)
- Ukuqhawukelwa ngumphefumlo
- I-Tachycardia (ixabiso lentliziyo ngokukhawuleza)
- Iintlungu zesifuba
- Intlungu zesisu
- Ukwandiswa kwemveliso yamathe
Iingxaki ezinzulu ezinxulumene nokulimala kwimeko enokuthi zenzeke ziyakwenzeka kwakhona kubandakanywa nokusebenza komzimba kwaye kungaquka ukufa. Ngenxa yobunzima bengozi, kufuneka uhlale udibana noLawulo lweTyhefu (800) 222-1222 .
Imveliso yokuPhepha
Iimveliso zeAlkaline
Imveliso eminingi yokucoca i-alkaline okanye iikhemikhali ezisisiseko. Imveliso yasemakhaya eyinokubangela ukonakaliswa kwe-caustic xa ingenayo ifakwe kwi-pH udidi lwe-11 ukuya kwe-14, nangona imveliso kunye ne-pH ye-8-10 ingabangela ukulimala okuthile. Iimveliso ze-alkaline omele uhlale kuzo ekufikeleleni kubantwana zibandakanya:
- Ukucoca i-cleaners: iLiquid Plumr kunye neDiquid liququ
- I-oven cleaners: I-Easy-Off
- Abaphuzi bezinwele: I-Revlon Creme Relaxer
- I-Ammonia ecocekileyo: Lysol All-Purpose, Windex
- Izitya zokuhlamba iimpahla: I-Tide, iPurex
Isithako esifanayo kwi-ejenti yokucoca i-sodium hydroxide. I-Lye kunye ne-caustic soda ngamanye amagama nge-sodium hydroxide, kodwa ingasetyenziswa njenge-hydroxyde ye-potassium.
I-hydrodide i-sodium iyindawo ehlambulukileyo yokucoca.
Ukulimala kwesisu kuya kuba nzima kakhulu kwimveliso ye-alkaline ngenxa yokuba isisu sakho esiswini sinokuphucula okanye silinganise ezinye ze-alkali. Nangona kunjalo, emlonyeni nasesigxeni, iimveliso ze-alkaline ziqala ukulimaza ngokukhawuleza izicubu kude kubekho umthamo phakathi kwezicubu ezithintela ngokwaneleyo umkhiqizo we-caustic. Ukulimala ngenxa yeemveliso ze-alkaline kuthiwa yi- necrosis ye-liquefactive , oku kuthetha ukuba umonakalo obulala iiseli ujika ezinye zezicubu zibe yifom ephosiweyo.
Iimveliso eziHlangeneyo
Ukulimala kwenzululwazi kwenzeka kancinci ngenxa yokuba iimveliso ezicacile zibangelwa ubuhlungu xa zisemlonyeni. Iimveliso ezixhamlayo zihlala zincinci, ezibangelwa umonakalo omncinci kumbindi njengoko i-liquid isifikela ngesisu ngokukhawuleza. Isisu esezantsi (eyaziwa ngokuba yi-antrum) yinto eqhelekileyo yomonakalo omkhulu owenzekayo njengoko ukuhamba kwezinto ezikhoyo ziyeka apha. Ukutya esiswini kuya kunceda ukunciphisa umonakalo owenzeka njengoko ukutya kungathabatha i-asidi. Iimveliso ezinamacandelo ane-pH ngaphantsi kwe-2 ziyingozi kakhulu. Imveliso ofuna ukuyigcina kubantwana iquka:
- Izitya zokuhlamba izitya: Lysol, Kaboom
- Abahlambululi bamanzi
- Ukukhupha ama-Rust: i-CLR (iCalcium, iLime, iRust), i-Evapo-Rust
Iimveliso ezinobungozi zenza umonakalo obizwa ngokuba yi- necrosis engxowanisayo , eyenza iifomthi kunye nezicubu ezinqabileyo kwindawo yomonakalo. Kukholelwa ukuba ngenxa yesithintelo sobunqamlezo kwaye oku ngaphantsi kudlalwa ngenxa yentlungu ebenziwayo emlonyeni ukuba umonakalo ophantsi kancinci kwenzeka ngokungenisa i-acids xa kuthelekiswa ne-alkali.
Kuthiwani NgeBleach?
I-Bleach i-alkali-caustic e-alkaline-agent, nangona kunjalo, kudla ngokungaqondi kakuhle njengoko kubangela ukulimala kakhulu. I-Bleach idayiswa ngokuqhelekileyo njengemveliso ye-pH engekho hlangothi (ithetha malunga ne-pH ye-7). Ngenxa ye-pH yokungathathi hlangothi, i-bleach empeleni ibhekwe njengento engathandekiyo kunezinto ezisisigxina. Ngokuqhelekileyo, ukungcola kwe-bleach kudinga kuphela ukujonga ngokuthe ngqo impawu ezibhalwe ngasentla. Nangona kukwahlula kuphela njengobunzima, ubunzima bokuphefumla kunye nezinye iziphumo ezichaphazelekayo ezinokuthi zenzeke ukuba ubungakanani bunokwaneleyo okanye buhlungu.
Ubunzima bokulimala
Ubunzima bokulimala kwe-caustic lilinganiswa ngokufanayo kwenkqubo efana nokutshisa . Nangona kunjalo, abanye oogqirha banako ukudibanisa ibakala lesi-4 kwingozi eyingozi.
- Ukukhupha (i-edema) nokubomvu (i-hyperemia)
- Ukuqhwala
- 2a - izilonda ezingekho phantsi kwendawo kunye nokukhupha iimbumba ezimhlophe
- 2b - izilonda ezinzulu kunye nokuphaphaza okwandisa ngaphaya kwendawo yokudibanisa
- Ukutshatyalaliswa kwezicubu
- 3a - inamba encinane yeemeko ezihlakazekile apho izicubu zifile
- 3b - indawo ezibanzi apho izicubu zifile
- I-Perforation - izicubu eziqhekekileyo okanye eziqhekekileyo ezikhokelela kwezinye iindawo zomzimba
Ubungakanani bokulimala bunokumiselwa ngokujonga ngendawo ngexesha le-endoscopic inkqubo ebizwa nge-EGD. Iziphumo ezintle zivame ukuba zenzeke ukuba ufumene ubunzima bebanga lesi-1 okanye ibakala lesi-2a; ukuphinda ngokuqhelekileyo kubakho. Ukuba unobungozi obunqanaba lesi-2b okanye ibanga lesi-3a, uya kuba ne-restriction engapheliyo ( izithintelo ) kwisayithi elenzakalisiweyo. Ibanga lesi-3b okanye 4 linomngcipheko omkhulu wokubangela ukufa; malunga neepesenti ezingama-65. Inkcazo eyongezelelweyo enikezelwe phantsi kweNyango ye-Caustic Ingestion .
Unyango
- Musa ukutshisa amalahle, njengoko engabophelanga kwizinto ezinobangela
- Ungaqhubeki ukuhlanza; ubungozi bokubambisa okwesibini kwe-esophagus, airways, umlomo, kunye neempumlo kwi-caustic substance
Emva kokuqaphela ukuba ukungena kwe-caustic (okanye i-potentially caustic) yenzeke, kufuneka uhlale uqhagamshelana noLawulo lweTyhefu. Kwakhona ngokuqhelekileyo kuthathwa njengophephile ukusela amanzi okanye ubisi emva kokongiwa kwe-alkaline okanye i-acidic substance ukuze kuhlanjululwe into. Nangona kunjalo, kufuneka uphephe ukusela kakhulu ngokugwema i-milliliters ezingaphezu kwe-15 zamanzi zonke iikhilogram (2.2 iipounds) zesisindo somzimba.
Akungabazeki ukuba uloyiko olusiphumo xa ufumanisa oko kwenzeka. Ukwazi oko unokulindela kunokuncedisa ukuphazamisa ukwesaba nokukuqhubela ukuba uthathe isenzo. Yazi ukuba yonke into eyenzekayo eyenziwa ngesizathu-kukunceda ufumane kwaye uqhubeke uphila kakuhle. Ulawulo lweTyhefu luyakunceda ukuba unqume ukuba ngaba awufuni ukuya esibhedlele. Nangona ukuba ukuphefumula kubonakala kunzima, kufuneka uhlale ubiza ii-EMS-IiNkonzo zezoNyango ezingxamisekileyo (911 e-United States), kwaye ufune uncedo lwonyango ngokukhawuleza. Ukuba amandla akho okugcina uhambo lwenkqantosi yinkxalabo, i-EMS okanye isebe lezengxamiseko (ED) ugqirha uya kufaka i-tube breath (intubation).
Ekufikeni kwisebe lexakeka, imfuneko yokuphela kwe-endoscopy (EGD) iya kuhlolwa. Ngokubanzi, i-EGD iya kwenziwa xa ukuvezwa kwenzeka phakathi kwama-12 no-48 iiyure. Ukuba uvavanyo luqhutywe kakhulu kusenokwenzeka, ubungakanani bomonakalo abukwazi ukubonakala ngokupheleleyo. Emva kweeyure ezingama-48 kwaye unobungozi bokuzilimaza ngokugqithisa ngokuphazamisa isisu kunye nobubanzi.
Ngokuxhomekeke kubukhulu bengozi, unokukhutshwa, ugcinwe kwiiyure ezingaphantsi kweeyure ezingama-24, okanye ungeniswe esibhedlele ukuze uqhubeke ulawulo lwenzakalo yakho. Ukuba ukulimala kwakho kunzima ngokwaneleyo, ityhubhu yokutya ingafakwa ngexesha le-EGD ukukhusela ukulimala okungakumbi "kwindawo engafumanga". Unokuba ne-tube yokutya esetyenziswe kamva phantsi kwe- fluoroscopy . Iza-antibiotics nazo ziya kuqalwa ngokuxhomekeka kwinqanaba lokulimala kunye nomngcipheko wosulelo. Okwangoku ayikho isiluleko esinamandla kwi-steroids, nangona kunjalo, ungayibona imiselwe kwezinye izicwangciso.
Ukuba uye wafumana ukulimala kanzima okanye akakwazanga ukwenza i-EGD eyenziwe ngaphambi kweeyure ezingama-48, ngoko uya kuba novavanyo lokungenisa i-barium ukuvavanya nayiphi na imingcipheko (izithintelo) okanye ukubethelwa kweenkonti (ukugqithiswa). Ukuba i-strictures ichongiwe, ngokuqhelekileyo iyakwenza i- dilutional dilation . Ukuba kufuneka ulandelelwano, unokulindela ukuba uvavanyo luza kwenziwa malunga neveki ezintathu emva koko.
Kwiimeko ezinzima kakhulu, ukuhlinzwa ngokutsha kwesifo sakho okanye ukususwa kwenxalenye yesifo (esophagectomy) kunokufuneka.
> Imithombo:
> Inyoni, uJH, Kumar, S, Paul, C & Ramsden, JD. (2016). Iingxabano ekulawuleni ukulimala komngcipheko wokubangela ingozi: ubungqina obujoliswe kubufakazi. Iiklinikhi yeOtolaryngol. i-doi: 10.1111 / coa.12819.
> Schoem, SR, Rosbe, KW & Bearelly S. (2015). I-Otolaryngology ye-Cummings: AmaQumrhu angaphandle kunye neeNkcazo zeCaustic. 6 th . Elsevier
> Triadafilopoulos, G. (2016). Ukulimala komzimba kubantu abadala. Kufumaneka ngomhla we-1/11/2017 ukusuka kwi-UpToDate (Ubhaliso olufunekayo).
> Weigert, A. (2005). Ingcinezelo ebangela abantwana. Qhubeka ufundisa u-Anaesth Crit Care Care Pain. 5 (1): 5-8. i-doi: 10.1093 / bjaceaccp / mki007
> Wightman RS, Funda iK KB, iHoffman RS. (2016). Ulawulo olusekelwe kuBu bungqina beCaustic Exposures kwiSebe eliPhezulu. Emerg Med Pract. 18 (5), 1-17