两起9例砷化氢中毒事故及病例研究

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目的分析砷化氢中毒事故原因,探讨砷化氢中毒的有效治疗措施。方法回顾分析2011年11月至2012年8月收治的两批9例砷化氢中毒病例的抢救治疗病史和中毒现场职业卫生学调查资料。结果 2起事故企业的生产原料中都含砷,在生产硫酸锌时产生砷化氢气体。因告知不够,缺乏防护,导致作业工人吸入砷化氢引起急性中毒。经激素、解毒、碱化尿液、水化、驱砷治疗,及血浆置换联合血液透析治疗(2例)、输注红细胞悬液(3例)治疗,预后良好,全部康复。结论有砷化氢逸散的设备应增加吸风装置,车间内配供氧式面罩。抢救砷化氢中毒患者,在肾损害不严重,且无进行性恶化趋势下,仅积极予以内科治疗亦能取得良好的治疗效果。驱砷剂的使用应根据病情密切关注。 Objective To analyze the causes of arsine poisoning and discuss the effective treatment of arsine poisoning. Methods A retrospective analysis was conducted on the rescue treatment history and poisoning occupational hygiene survey data of 9 cases of arsine poisoning treated in two batches from November 2011 to August 2012. Results 2 accidents Arsenic was contained in the production raw materials of the enterprises, and arsine gas was produced when producing zinc sulfate. Insufficient notification, lack of protection, causing workers to inhale arsine to cause acute poisoning. Hormone, detoxification, alkalization of urine, hydration, arsenic-arsenic treatment, and plasma exchange combined with hemodialysis treatment (2 cases), transfusion of erythrocyte suspension (3 cases) treatment, the prognosis was good, all recovered. Conclusion Arsine hydrogen fugitive equipment should increase the suction device, the workshop equipped with oxygen masks. Rescue of patients with arsine poisoning, kidney damage is not serious, and no progressive deterioration of the trend, only actively to medical treatment can achieve good therapeutic effect. The use of arsenic removal should be based on the condition of close attention.
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