问题 问答题 简答题

硫化氢中毒临床症状和体征

答案

参考答案:

硫化氢可引起刺激反应,急性中毒和慢性损害。

(一)刺激反应接触后出现眼刺痛、畏光、流泪、流涕、结膜充血、咽部灼热、咳嗽等眼和上呼吸道刺激症状,以及头痛、头晕、乏力、恶心等神经系统症状。脱离接触后短时间内可恢复。

(二)急性中毒急性中毒可累及中枢神经系统、呼吸系统、心、肝等多器官系统。吸入较低浓度硫化氢即产生眼和呼吸道黏膜的刺激表现,浓度愈高对中枢神经系统的作用和窒息作用愈明显。高浓度和极高浓度硫化氢可使呼吸麻痹和心搏骤停。按程度分为轻、中、重三级。

1.轻度中毒表现为畏光、流泪、眼刺痛、异物感、流涕、鼻及咽喉灼热感等症状,检查可见眼结膜充血、肺部干啰音等,此外,还可有轻度头晕、头痛、乏力症状。

2.中度中毒表现为立即出现头昏、头痛、乏力、恶心、呕吐等症状,可有短暂意识障碍,同时可引起呼吸道黏膜刺激症状和眼刺激症状,检查可见肺部干性或湿性啰音,眼结膜充血、水肿等。

3.重度中毒表现为明显的中枢神经系统的症状,首先出现头晕、心悸、呼吸困难、行动迟钝,继而出现烦躁、意识模糊、呕吐、腹泻、腹痛和抽搐,迅速进入昏迷状态,最后可因呼吸麻痹而死亡。在接触极高浓度的硫化氢时,可发生"电击型"死亡,接触者在数秒内突然倒下,呼吸停止。

(三)后遗症部分严重中毒患者经治疗后可留有后遗症,如头痛、失眠、记忆力减退、自主神经功能紊乱、紧张、焦虑、智力障碍、平衡和运动障碍、周围神经损伤等,头颅CT显示轻度脑萎缩等。

(四)慢性危害长期接触低浓度硫化氢可引起眼及呼吸道慢性炎症,如慢性结膜炎、角膜炎、鼻炎、咽炎、气管炎和嗅觉减退,甚至角膜糜烂或点状角膜炎等。全身症状可有类神经症、中枢性自主神经功能紊乱,如头痛、头晕、乏力、睡眠障碍、记忆力减退和多汗、皮肤划痕征阳性等。也可损害周围神经。

阅读理解
根据短文内容,从下框的选项中选出能概括每一段主题的最佳选项。选项中有一项为多余项。
A. Know your introduction and your conclusion.
B. Channel your nervous energy.
C. Know your audience.
D. Use deep-breathing techniques.
E. Be prepared
F. Select an appropriate topic.
How you calm yourself before giving a speech? Both modern research and centuries of experience from experienced public speakers suggest some practical advice.
小题1:_____
Know to whom you’ll be speaking, and learn as much about your audience as you can. The more you can anticipate the kind of reaction your listeners will have to your speech, the more comfortable you’ll be in delivering your message. Be audience-centered rather than speaker-centered.
小题2:_____
You will feel less nervous if you talk about something you are familiar with or have some personal experience of. Your comfort with the subject of the speech will be reflected in your delivery.
小题3:_____
The better prepared you are, the less anxiety you will experience. Being prepared means that you have researched your topic and practiced your speech several times before you deliver it.
小题4:_____
You are likely to feel the most anxious during the opening moments of your speech. Therefore, it is a good idea to have a clear plan for how you will start your speech. Being familiar with your introduction will help you feel more comfortable about the entire speech. If you know how you will end your speech, you will have a safe harbour in case you lose your place. If you need to end your speech ahead of time, a well-delivered conclusion can permit you to make a graceful exit.
小题5:_____
One of the symptoms(症状) of nervousness is a change in your breathing and heart rates. Nervous speakers tend to take short, shallow breaths. To help break the anxiety—reduce breathing pattern, consider taking a few slow deep breaths before you rise to speak.
单项选择题