Carbon tetrachloride poisoning

Introduction

Introduction to carbon tetrachloride poisoning Carbontetrachloride (CCl4) is a colorless liquid. It is a good solvent in industrial production. It is also used as a dry cleaning agent, fire extinguishing agent and fumigant. When CCl4 encounters a flame or a hot metal surface, it can be decomposed into phosgene and hydrogen chloride, and the toxicity is increased. People have great susceptibility to CCl4 toxicity. After inhaling high concentrations of CCl4 vapor, acute toxic symptoms such as coma and convulsion can occur rapidly. basic knowledge The proportion of sickness: 0.00001% Susceptible people: no specific population Mode of infection: non-infectious complication:

Cause

Causes of carbon tetrachloride poisoning

CCl4 and its decomposition products can be absorbed through the respiratory tract, and the skin contact is absorbed quickly. It is rapidly metabolized in the body. About 50% of it is excreted from the lungs after inhalation, 20% is oxidatively transformed in the body, and the final product is carbon dioxide. CCl4 has a central nervous system. Anesthesia also damages the peripheral nerves, but the more prominent is liver damage. CCl4 acts on hydroxylase in the endoplasmic reticulum of hepatocytes, producing free radicals-C·Cl3, which undergo lipid peroxidation, which changes the endoplasmic reticulum. Enzyme rupture and mitochondrial damage and changes in calcium ion permeability cause hepatocyte necrosis, which is a possible cause of liver damage. In addition, CCl4 can also cause degeneration and necrosis of renal tubular epithelial cells, leading to kidney damage.

Prevention

Carbon tetrachloride poisoning prevention

The process of producing carbon tetrachloride requires strict sealing. The process of using carbon tetrachloride should be adequately ventilated. When entering a high concentration of carbon tetrachloride working environment, it is necessary to wear a filter or oxygen mask, using carbon tetrachloride. Fire extinguishers should wear gas masks, pay attention to the danger of phosgene poisoning, popularize prevention knowledge, publicize contacts not to drink alcohol, disable carbon tetrachloride hand washing or wash work clothes, and do a good job health check and regular health check. Patients with renal and organic neurological disorders should not be exposed to carbon tetrachloride.

Complication

Complications of carbon tetrachloride poisoning Complication

Complications such as clinical manifestations of the central nervous system and/or liver and kidney damage may occur.

Symptom

Symptoms of carbon tetrachloride poisoning Common symptoms convulsions abdominal pain kidney damage diarrhea hepatomegaly edema nausea

Human susceptibility to CCl4 is very different. After inhaling high concentration of CCl4 vapor, acute toxic symptoms such as coma and convulsion can occur rapidly, and pulmonary edema, respiratory paralysis, slightly high concentration inhalation, mental inhibition, confusion, and nausea can occur. , vomiting, abdominal pain, diarrhea, poisoning on the 2nd to 4th day showed liver, kidney damage signs, severe ascites, acute liver necrosis and renal failure, a few may have myocardial damage, atrial fibrillation, ventricular premature beats, oral poisoning, liver Symptoms are obvious. Chronic poisoning is characterized by neurasthenic syndrome and gastrointestinal dysfunction. A few may have hepatomegaly and abnormal liver function, rare renal function damage, and few optic neuritis and peripheral neuritis.

Examine

Inspection of carbon tetrachloride poisoning

1. Liver function test: serum ALT, AST activity increased significantly, can be used as the main diagnostic indicator of liver damage in the acute phase of carbon tetrachloride poisoning, serum hepatic acid, serum prealbumin and other measurements are also sensitive indicators, severely damaged At the time, serum bilirubin and prothrombin time were significantly increased, while serum albumin was significantly reduced.

2. Urine routine and renal function tests: Changes in urine composition may indicate early evidence of renal dysfunction, blood urea nitrogen, creatinine increase, endogenous creatinine clearance is a common and sensitive measure of glomerular filtration rate (GFR) The method for the diagnosis of acute renal failure can be considered in patients with a GFR drop of more than 50%.

3. Determination of the concentration of carbon tetrachloride in blood and exhaled breath can be used as a diagnostic reference.

Diagnosis

Diagnosis and identification of carbon tetrachloride poisoning

diagnosis

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Differential diagnosis

When acute poisoning occurs in a coma, attention should be paid to the identification of epidemic cerebrospinal meningitis, epidemic encephalitis and other infectious diseases, and liver and kidney damage should be associated with viral hepatitis, drug-induced liver disease, renal diseases and other diseases. Toxicity, kidney disease identification.

Chronic poisoning should be differentiated from viral hepatitis, drug-induced liver disease and alcoholic liver disease.

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