不溶性钙盐离子积在磷及氢氟酸烧伤中毒救治中的参考作用

The Ion Product of Calcium Fluoride and Phosphate in the Treatment of Fluoride and Phosphorus Poisoning Postburns

目的根据不溶性钙盐离子积计算,将血钙控制于正常水平,从而将血磷酸与氟控制在致死性浓度以下,达到解救磷与氢氟酸烧伤中毒目的。方法氢氟酸与黄磷于新西兰兔背部皮肤致致死性磷与氢氟酸烧伤,伤后动物分为:氢氟酸烧伤组(HF,n=10);氢氟酸烧伤钙治疗组(HF-Ca,n=10);磷烧伤组(P,n=12)与磷烧伤钙治疗组(P-Ca,n=12),汽油烧伤对照组(G,n=12)。两治疗组均给予钙治疗以将血钙水平控制在正常水平以上,观测伤后死亡率与血氟、磷、血总钙、游离钙水平。结果氢氟酸烧伤组伤后血氟(1.15±0.12)×10-4mol/L,动物死亡率100%;磷烧伤后血磷显著升高,动物死亡率75%;两组血游离钙均较正常显著降低(P<0.05),钙治疗将血钙维持于正常水平后,7 d内动物死亡率降低至普通烧伤的30%水平。结论维持血钙于正常水平能够防治磷及氢氟酸烧伤致死性中毒,这一结果能够从不溶性盐离子积计算中加以解释。

Objective To treat the fatal of poisoning after chemical bums, the plasma fluoride and phosphate could be kept below the fatal levels as the plasma calcium was maintained at normal, according to the ion product of Calcium phosphate and CaF2 . Methods Hydrofluoric acid, phosphorus was applied to the skin of healthy rabbits to produce fatal chemical bums, and they were randomly divided into five groups, i. e hydrofluoric acid bum without treatment （HF, n = 10） and those with calcium treatment group （HF-Ca, n = 10）, and phosphorus bum without treatment （P, n = 12） and those with calcium treatment group （P- Ca, n= 12）, and Gasoline bum as control（ G, n = 12）.In two treatment the plasma ioned calcium was kept at normal level by intravenous drop of calcium gluconate postbums, The plasma fluoride, phosphate, total and ioned calcium as well as mortalities were investigated. Results The fluoride in plasma was （1.15± 0. 12）× 10^-4 mol/L with 100% of mortality in HF bum. The plasma phosphate increased significantly with 76% of mortality in P bum. The plasma ioned calcium level decreased significantly in both groups than G group.The When the plasma ioned calcium level have been remained normal in HF-Ca and P-Ca group, their mortalities were closed to that in G group. Conclusion Keeping the plasma calcium in normal level by giving calcium intravenousely could prevent and cure the poisoning after hydrofluoric acid and phosphorus bums. It was based on the calculations of ionic dissociation of calcium fluoride and calcium phosphate.