Ekologiya cheloveka (Human Ecology)Ekologiya cheloveka (Human Ecology)Экология человека1728-08692949-1444Eco-Vector1746310.17816/humeco17463ArticlesСтатьиResearch ArticleACUTE OCCUPATIONAL INTOXICATIONS BY CHLORINE AND AMMONIA: CLINICAL PICTURE, DIAGNOSTICS AND TREATMENT. CURRENT CONCEPTIONSОстрые производственные отравления хлором и аммиаком: клиника, диагностика, лечение. Современные представленияAkimovA GАкимовАндрей Геннадьевич

доктор медицинских наук, профессор кафедры военно-полевой терапии

a-and@yandex.ruKhalimovYu ShХалимовЮ ШShilovV VШиловВ ВMilitary Medical Academy named after S. M. KirovВоенно-медицинская академия им. С. М. КироваNorthwest Public Health Research CenterСеверо-Западный научный центр гигиены и общественного здоровья15062012196NO6 (2012)№6 (2012)253623102019Copyright ©; 2012, Akimov A.G., Khalimov Y.S., Shilov V.V.Copyright ©; 2012, Акимов А.Г., Халимов Ю.Ш., Шилов В.В.2012Akimov A.G., Khalimov Y.S., Shilov V.V.Акимов А.Г., Халимов Ю.Ш., Шилов В.В.https://creativecommons.org/licenses/by-nc-nd/4.0https://hum-ecol.ru/1728-0869/article/view/17463

Current issues of industrial accidents resulting in chlorine and ammonia emissions have been considered in the article. In general, chlorine damage pathogenesis is related to the effect of acids generated in the process of its interaction with water, the effect of active oxygen forms, resulting in respiratory tract damage, surfactant damage and oxidative stress. Ammonia intoxication consequences are mainly caused by the local effect of ammonium hydroxide generated during interaction between ammonia and water on the airways’ and ocular mucosa. High ammonia concentrations result in NMDA receptor activation and ATP amount depletion. Pulmonary toxicant damage treatment covers reduction of the airways’ and ocular mucosa irritation phenomena, use of β-adrenergic receptor agonists; oxygen, corticosteroid and symptomatic medication by indications. Stage-by-stage treatment of the damage has been discussed.

В статье рассмотрены актуальные вопросы техногенных аварий, сопровождающихся выбросом хлора и аммиака. Патогенез поражений хлором в основном связан с воздействием кислот, образующихся при его взаимодействии с водой, и влиянием активных форм кислорода, приводящих к повреждению дыхательных путей, повреждению сурфактанта и оксидативному стрессу. Последствия отравления аммиаком в основном обусловлены местным действием гидроксида аммония, образующегося при взаимодействии аммиака и воды на слизистых оболочках дыхательных путей и глаз. Большие дозы аммиака ведут к активации NMDA-рецепторов и истощению запасов АТФ. Терапия поражений пульмонотоксикантами включает купирование явлений раздражения слизистых оболочек глаз и дыхательных путей, применение агонистов β-адренорецепторов, по показаниям кислорода, кортикостероидов, препаратов симптоматической терапии. Рассмотрено этапное лечение поражений.

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