六氟灵对兔眼氢氟酸灼伤应急洗消作用研究

Study on effects of hexafluorine on emergent decontamination of rabbit eye burns induced by hydrofluoric

目的评价六氟灵洗消剂对氢氟酸眼灼伤的应急洗消效果。方法 18只无特定病原体级新西兰白兔随机分为溶剂对照组、葡萄糖酸钙组和六氟灵组,每组6只,采用浓度为1.0 mol/L氢氟酸建立眼灼伤模型后,分别采用生理氯化钠溶液、葡萄糖酸钙溶液和六氟灵溶液各500 ml洗消10 min。采用同体左右侧自身对比法,肉眼(眼刺激反应分值)和激光多普勒(测血流量)分别观察在体洗消后6、24、48和72 h时的效果。眼洗消实验前,采用体外中和实验观察上述3种洗消液的中和作用。结果质量分数为9.0%六氟灵、2.5%葡萄糖酸钙溶液各20.0 ml可使1.0 ml浓度为1.0 mol/L氢氟酸溶液的pH值中和至6.5、3.5,并使氟离子电位升高至250、210 mV,而生理氯化钠溶液对上述2个指标无明显影响。洗消后24 h,溶剂对照组家兔暴露眼角膜出现明显浑浊,虹膜肉眼可见坏死,结膜充血水肿严重,出现大量分泌物;葡萄糖酸钙组家兔暴露眼损伤症状较溶剂对照组减轻,但部分角膜出现浑浊,结膜充血水肿;六氟灵组家兔暴露眼角膜未出现明显浑浊,仅见结膜轻度充血。激光多普勒血流成像显示,洗消后24 h,正常对照组眼结膜区未见明显血流,溶剂对照组结膜血流明显多于葡萄糖酸钙组和六氟灵组,六氟灵组结膜血流相对最少。六氟灵组眼刺激反应分值分别低于溶剂对照组和葡萄糖酸钙组(P<0.01);洗消后4个时间点间眼刺激反应分值两两比较,差异均有统计学意义(P<0.01);洗消72 h后溶剂对照组仍呈现明显的眼损伤,六氟灵组则恢复至接近正常水平。结论六氟灵对氢氟酸溶液的氢离子及氟离子具有快速、完全中和作用,能明显减轻氢氟酸导致的眼灼伤。

Objective To evaluate the effectiveness of emergency flushing with hexafluorine on hydrofluoric acid （ HF） eye splashes.Methods Eighteen specific pathogen free New Zealand white rabbits were randomly and evenly divided into three groups , solvent control group , calcium gluconate group , and hexafluorine group .Eye burns models were made by using 1.0 mol/L hydrofluoric acid , and then they were rinsed immediately with appropriate 500 ml normal saline , calcium gluconate and hexafluorine for 10 minutes respectively .The same rabbit ’ s left and right eye were served as a contrast to observe the decontamination effect in vivo after flushing for 6, 24, 48 and 72 hours respectively.The damages were exam-ined by means of the naked eyes （ eye irritation scores ） and laser doppler perfusing imaging （ to measure the blood flow ） . Before the decontamination experiment of eyes , the neutralizing effect of the above three kinds of decontaminating agents were observed by neutralization experiment in vitro.Results Normal saline had little effect on either pH and fluoride ionic potential of HF solution, whereas addition 20.0 ml of 9.0%（mass fraction） hexafluorine or 2.5%（mass fraction） calci-um gluconate to 1.0 ml （ the concentration of 1.0 mol/L） HF solution gave a final pH 6.5, 3.5 and fluoride ionic potential 250 mV and 210 mV respectively .The exposed eyes of solvent control group showed a series of phenomena of significant corneal opacification , iris visible necrosis , conjunctival hyperemia edema with the emergence of a large number of secre -tions after rising for 24 hours.The exposed eyes＆#39;injury symptoms of calcium gluconate group were lighter than those of sol-vent control group , but appearing part of the cornea cloudy and conjunctival congestion edema .The cornea remained clear and only mild conjunctival hyperemia edema were observed in hexafluorine group .The laser doppler perfusing imaging showed that the conjunctiva area of normal control group did not appear obvious blood flow after decontamination for 24＆amp;nbsp;hours.The conjunctival blood of solvent control group was obviously more than those of calcium gluconate group and hexafluorine group .The conjunctival blood of hexafluorine group was the least relatively in the three groups .The eye irrita-tion scores of hexafluorine group were lower than those of solvent control group and calcium gluconate group respectively （P＆lt;0.01）.The eye irritation scores between four time points after decontamination were compared with each other , and the differences had statistical significance （ P＆lt;0.01 ） .The solvent control group still appeared obvious eye damage 72 hours after decontamination , while hexafluorine group returned to normal levels .Conclusion Hexafluorine could be the most efficacious decontaminant against HF eye splashes owing to its characteristics of rapid and complete neutralization to HF and reduce ocular burn damage significantly .