Benzene poisoning
Introduction
Introduction to benzene poisoning Benzene is an aromatic hydrocarbon compound obtained from fractional distillation of coal tar and petroleum cracking. It is an oily liquid with a colorless and aromatic odor. Very volatile, flammable and explosive. Industrially used as a solvent, diluent and chemical raw material. Benzene is a moderately toxic substance that can cause acute or chronic poisoning. Acute benzene poisoning refers to the pathophysiological process in which central nervous system anesthesia is the main manifestation after oral administration of benzene-containing organic solvents or inhalation of high concentrations of benzene vapor; chronic benzene poisoning means that benzene and its metabolite phenols directly inhibit cells. Nuclear fission leads to cell mutations that affect the hematopoietic function of the bone marrow. Clinical manifestations of a continuous reduction in white blood cell counts eventually lead to aplastic anemia or leukemia. basic knowledge The proportion of illness: 0.065% Susceptible people: more common in shoemakers Mode of infection: non-infectious Complications: anemia
Cause
Causes of benzene poisoning
Environmental factors (50%):
Inhalation of benzene vapor or skin contact with benzene caused by poisoning, there are acute, chronic points. Acute benzene poisoning mainly produces anesthesia to the central nervous system, coma and muscle twitching; high concentrations of benzene have a stimulating effect on the skin. Long-term low concentration of benzene can cause chronic benzene poisoning, hematopoietic disorders, early reduction of common white blood cell count, and then the reduction of platelet count and anemia. Patients may have clinical manifestations such as epistaxis, bleeding gums, subcutaneous hemorrhage, and menorrhagia.
Mistaken (30%):
Acute benzene poisoning is mostly caused by accidental or acute inhalation of organic solvents containing benzene. These organic solvents include paints, thinners, industrial glues, and the like. Chronic benzene poisoning is caused by long-term inhalation of low concentrations of benzene and metabolite phenols.
Prevention
Benzene poisoning prevention
For patients with acute poisoning, you can immediately leave the site to fresh air, remove contaminated clothing, and wash contaminated skin with soap or water. Oral poisoning, patients should be gastric lavage, poisoned people should rest in bed, and receive symptomatic, supportive treatment, can be given glucuronic acid. Should pay attention to prevent patients with cerebral edema, remember not to use adrenaline for heartbeat, for patients with aplastic anemia caused by benzene poisoning, can be given a small number of multiple blood transfusions and glucocorticoid treatment.
Complication
Benzene poisoning complications Complications anemia
Benzene causes congenital defects in the fetus. Long-term inhalation of benzene (about 1 to 2 months) can cause aplastic anemia. However, if it is found early and is in contact with benzene, it can be cured after proper treatment.
Symptom
Symptoms of benzene poisoning common symptoms gait instability nausea sensory disturbance convulsion leukopenia
1. Mild poisoning may have headache, dizziness, tearing, dry throat, cough, nausea and vomiting, abdominal pain, diarrhea, gait instability; skin, nail and mucous purpura, acute conjunctivitis, tinnitus, photophobia, palpitations and complexion Pale and other symptoms.
2, moderate and severe poisoning, in addition to the above symptoms worse, drowsiness, unresponsiveness, delirium, etc., may also quickly coma, rapid pulse, blood pressure, body skin, mucous membrane purpura, rapid breathing, convulsions, muscle tremor Some patients may also have agitation, euphoria, paralysis and peripheral nerve damage, and even difficulty breathing, shock.
Examine
Inspection of benzene poisoning
Blood routine test: Do not draw conclusions based on one result or simple review result. According to the results of multiple review, take full account of the error factors and take the stable value and combine the overall data analysis, and then draw conclusions. If necessary, observe a period of time. Then diagnose.
Bone marrow examination: it is conducive to understanding the condition of hematopoietic damage. In patients with chronic poisoning, there is a great time for the diagnosis and differential diagnosis of a certain blood cell abnormality, pancytopenia, aplastic anemia, myelodysplastic syndrome, leukemia. help.
Neutrophil alkaline phosphatase activity and determination of neutrophil granules.
Diagnosis
Diagnosis and identification of benzene poisoning
Acute benzene poisoning diagnosis is not difficult, can be based on the history of toxic exposure and clinical manifestations; chronic benzene poisoning, in addition to the history of toxic exposure and clinical manifestations, but also according to blood, bone marrow and other related blood laboratory tests, and other can cause The cause of blood changes is diagnosed and diagnosed. In addition, there is a certain reference value for the determination of urinary phenol. The normal value of urinary phenol varies widely from 132 mol/L to 253 mol/L (12.4 mg/L to 23.8 mg/L).
Acute benzene poisoning needs to be differentiated from acute poisoning of other organic solvents such as toluene, xylene, acetone, etc., and it needs to be differentiated from cerebrovascular accidental coma, hypoglycemia and fainting.
