Chinese girlfriend gives boyfriend intravenous mercury! What matter? -Mercury poisoning, mercury-IT information
Recently there have been a few news to detonate your circle of friends, can be summed up as: girlfriend, not of medical knowledge!
News is a nurse in Shanghai because of emotional problems, to fiance use sleeping pills, intravenous high-dose insulin, so that it eventually died of respiratory depression and severe low blood sugar.
Second news is some girlfriends because of emotional problems too, using sleeping pills to her boyfriend after intravenous injection of mercury, led to her boyfriend on the line, still in ICU rescue, the result is not optimistic!
See chart below:
What is mercury?
In fact, mercury is "Mercury" nickname, mercury is a chemical element in the periodic table of elements is in 80th place. it is the only liquid metal on Earth, mainly with metallic mercury or mercury vapor and inorganic mercury or mercuric salts and organic mercury compounds 3 forms, can evaporate at room temperature.
In China the use of mercury in ancient times, such as historical records in the tomb of Qin Shi Huang to substitute large amounts of mercury in rivers and lakes, and like many Chinese medicine containing "Mercury".
As the 2006 News: "the United Kingdom drug safety agency released information, called" fufang luhui capsules "of traditional Chinese medicine, tested mercury levels found in the drug more than United Kingdom standard 117,000 times".
May 2013: "Beijing Tong ren Tang has a section named" fitness fill five pill "medicines due to mercury levels exceeding limits of 5 times, was ordered by the Hong Kong Department of health is withdrawn from the market. Hong Kong Department of Health said in a notice, the Department of health found during routine monitoring "exercise for all five pill supplement" (registration number: HKP-08760, batch number: 1033946) samples for mercury content limit is about 5 times, and therefore ordered withdrawn. ”
For most ordinary people are rarely directly exposed to mercury, thermometers, normal, blood pressure monitors, lights, nothing more than traditional Chinese medicine preparation. Common ways of mercury poisoning: vapor inhalation; intravenous and topical.
The most common poisoning: mercury mining extraction, smelting, gold and silver lights, gauges, thermometers, paints, pharmaceutical and other industry workers; or accidental ingestion of mercury salt mercury drug poisoning; prescriptions of traditional Chinese medicine.
Several cases such as the following:
1, 26 years old female patient. Failure of their marriage, tried to commit suicide several times, one of her with a syringe 5 vein injected into the mercury in the thermometer right elbow and chest tightness, shortness of breath, abdominal pain and bleeding gums. Admission blood mercury 4000nmol/l; brain, lungs, pelvis metallic foreign bodies can be seen. Developed with multiple organ failure. Since mercury and its compound poisoning can cause system damage, renal accumulation and is the main excretory organ, it can cause acute renal tubular necrosis to cause renal failure. The patients after active treatment such as dialysis, improved and discharged after about 40 days!
2, 32 years old male patient with bilateral lower limb joint pain at a local clinic for treatment, clinic doctors with a homemade white powder coated acupuncture bleeding sites, each day of treatment, a total of 20 times. And then began to have headaches, heart palpitations, insomnia, changes and emerging upper limb tremors and memory loss. 2 months later due to illness to diagnosis and treatment in the General Hospital, findings of acute mercury poisoning. Later confirmed the white powder containing mercury!
3, 52-year old male patient, when heated in a gold smelting gold metallic mercury, inhalation of mercury vapors appears after the 2-hour full body tremors, fever, chest tightness, shortness of breath, bleeding gums, pain, and diarrhea. After admission examination found severe kidney damage, liver damage and illness continue to increase. Inhalation of mercury vapour on extremely serious and irreversible lung damage! People 1.2-8.5mg/m^3 inhalation of mercury vapors can lead to acute mercury poisoning! Long-term exposure to low concentrations of mercury vapor can also occur with chronic mercury poisoning. The patients be anti-inflammatory drive mercury, nutrition, heart and liver kidney, keeping water and electrolyte balance, ventilator-assisted ventilation, symptomatic treatment, but patients still in hospital died 14th day!
4, 6 years old male patient, for nausea and vomiting with diarrhea and urine for 3 days in hospital. 3 days days ago suddenly began violently vomit, vomit emerge Brown and bright red, intermittent abdominal pain, dilute solutions has more than 10 times, urine decreases, and the lower limb swelling. Sound check after admission, with blood mercury 6000nmol/l! although there is no clear history of exposure to mercury and the history of poisoning, and was diagnosed as acute mercury poisoning and acute renal failure. Hemodialysis treatment, improved after 35 days of discharge.
5, 9 months, twin, three hours coughing, wheezing, difficulty breathing, twitching of extremities. Third admission days after the brother died, sister improved and discharged a week later. Also have been diagnosed with acute poisoning by mercury vapor. Prior to the onset of a twin brother and sister sleeping at home, Dad smoked mercury in gold at home!
6, 34 year old female patient, for a mall salesperson. 2 months ago began to break in using a certain brand of whitening day cream, night cream. Emerging low back pain, oliguria, fatigue, edema, excessive sweating. After admission to mercury poisoning was diagnosed. Testing the brand day cream, night cream are excessive mercury in!
7, 48 year old rural housewife, because "hair loss, scalp sores March" local treatment of traditional Chinese medicine, oral medicine in February, the self-made drug of traditional Chinese medicine for external use on 10th. Oral hemorrhage occurred gradually, lower extremity edema, recurrent fever, sweating, palpitation, and diagnosis and treatment to local community health centers, misdiagnosed as rheumatic disease. Hospital three days after illness, and referral. Later identified as acute mercury poisoning, and died!
There are many similar cases. For these acute mercury poisoning, the main clinical manifestations include:
1, digestive symptoms : nausea, vomiting, abdominal pain, diarrhea, bloody stools and other symptoms.
2, Oral lesions : canker sores, bleeding gums, loose teeth can appear, and so on.
3, nervous system : dizziness, headache, insomnia, fatigue, tremors, coma, etc.
4, the urinary system : to have back pain, oliguria or anuria, lower extremity or generalized edema and other symptoms of acute renal failure.
5, the respiratory system : cough, chest tightness, shortness of breath, difficulty breathing, chest pain, fainting, etc.
6, hematologic : thrombocytopenia can occur, also can cause aplastic anemia.
Wang hanbin, Niu Wenkai the mercury poisoning in diagnosis and treatment of mercury poisoning in the specific mechanism has the following description:
"Mercury vapor absorbed by the respiratory tract, amount of mercury absorbed by the digestive tract is relatively small, about one out of 10,000 of the intake, mercury and salt absorption in the digestive tract of about 10%. Mercury salts can also be absorbed by the skin and mucous membranes.
After entering the blood of metallic mercury and mercury compounds, can oxidize Divalent mercury ions in the blood, which combined with plasma protein, hemoglobin, forming protein combined with mercury. Mercury can also be combined with the anion in body fluids or with the sulfhydryl-containing low molecular weight compounds, such as cysteine, reduced glutathione combined, form a diffusion of mercury. Both types of mercury distribution in tissues and organs, with the highest content of kidney. Mercury vapor inhalation, can enter the brain through the blood-brain barrier!
Mercury many nonspecific inhibitors of the enzyme. Mercury has high affinity to thiol, two sulfhydryl, have important biological activities in the body associated with the sulfhydryl enzymes such as cytochrome oxidase, succinate Dehydrogenase activity lost; mercury with amino, carboxyl, combination of phosphoryl group to influence gene activity.
Due to the activity of these enzymes and genes affected and hindered the normal biological activity and metabolism of cells, ultimately resulting in necrosis and degeneration, caused by dysfunction of the central nervous system and the autonomic nervous system, kidney and other organ damage. ”
How to deal with suspected acute mercury poisoning?
1, immediately leave the scene, not without medication!
2, early treatment, early gastric lavage and catharsis (careful gastric lavage of stomach bleeding, and do not use gastric lavage with normal saline)
3, mercury displacement treatment: sodium dimercaptopropane sulfonate, penicillamine, and, two-dimercapto-succinic, sodium dimercaptopropane, and so on. These drugs with sodium dimercaptopropane sulfonate as preferred. This kind of heavy metal chelating agent, can take the place of mercury ion in the sh groups, excluded form the mercury compound from urine, achieve the purpose of mercury displacement therapy!
4, other symptomatic treatment.
Mercury poisoning would bring great harm to the body and expect very poor, but we do not need extremely suspicious. Because in life we can rarely be directly exposed to the mercury, and rarely had access.
However, it is important:
Careful use of Chinese herbs, especially those containing mercury or drug with unknown contents!
中国最狠女友给男友静脉注射水银！究竟咋回事？ - 水银中毒,水银 - IT资讯
最近先后有几则新闻引爆朋友圈，可以归纳为：有医学知识的女友惹不起！
一则新闻是上海某护士因为感情问题，给未婚夫使用安眠药后静脉推注大剂量胰岛素，使其最终死于呼吸抑制和严重低血糖。
二则新闻是某女友同样因感情问题，给男友使用安眠药后静脉注射水银，导致男友命悬一线，仍在ICU抢救之中，结局不容乐观！
见下图：
那什么是水银？
其实水银是“汞”的俗称，而汞是一种化学元素，在元素周期表中排在第80位.它是存在于地球的惟一液态金属元素，主要有金属汞或汞蒸气、无机汞或汞盐以及有机汞化合物3种形态，在常温中便可以蒸发。
在我国对汞的使用古已有之，比如史书记载在秦始皇的墓中便以大量的水银代替江河湖海，又比如很多中医药物之中含有“汞”。
如2006年的一则新闻：“英国药物安全机构发布信息，一种名叫“复方芦荟胶囊”的中药，经检测发现该药物中的汞含量超过英国标准11.7万倍”。
再如2013年5月：“北京同仁堂一款名为“健体五补丸”的中成药因水银含量超出上限标准5倍，被香港卫生署下令从市面收回。香港卫生署在通告中称，卫生署人员在日常监测中发现“健体五补丸”（注册编号：HKP-08760，批次编号：1033946）样本水银含量为上限标准的约5倍，因此下令收回。”
其实对于大多数普通人来说很少能够直接接触到水银，无非体温计、普通血压计、照明灯、中药制剂。常见的汞中毒途径：蒸气吸入；静脉注射；局部涂抹。
最常见的中毒方式：汞矿开采冶炼、金和银提取、照明灯、仪表、温度计、颜料、制药等产业的工人；误服汞盐或含汞药物；投毒；中药偏方。
比如下面几个病例：
1、26岁女性患者。因婚姻失败，多次尝试自杀，其中一次她用注射器抽取5支体温计内的汞注射入右侧肘静脉，后出现胸闷、气短、腹痛、牙龈出血。入院后查血汞4000nmol/l；颅内、肺脏、盆腔均可以看见金属异物。逐渐出现多脏器功能衰竭。因为汞及其化合物中毒可以引起多系统损伤，其中肾脏是主要蓄积和排泄器官，它可以导致急性肾小管坏死进入引起肾功能衰竭。这个患者经过血液透析等积极治疗，约40天后好转出院！
2、32岁男性患者，因为双下肢关节疼痛在当地某诊所治疗，诊所医生用自制白色粉末涂抹在针刺出血后的部位，每个一日治疗一次，总共治疗20次。然后开始出现头痛、心悸、失眠，性情改变，并逐渐出现上肢震颤和记忆力下降。2个月后因病情加重到综合医院诊治，检查发现为急性汞中毒。后来证实这种白色粉末含有水银！
3、52岁男性患者，在金矿冶炼金子加热金属汞时，吸入汞蒸气2小时后出现全身震颤、发热、胸闷、气短、牙龈出血、腰痛、腹泻。入院后检查发现严重肾功能损伤、肝功能损伤，病情持续加重。汞蒸气吸入对肺的伤害极其严重而且不可逆转！人吸入1.2-8.5mg/m^3的汞蒸气便可以导致急性汞中毒！长期接触低浓度的汞蒸气也可以出现慢性汞中毒。这个患者虽然予以抗炎驱汞、营养心肌、护肝保肾、维持水电平衡、呼吸机辅助通气等对症处理，但是患者仍于入院第14天抢救无效死亡！
4、6岁男性患者，因为恶心呕吐伴腹泻、无尿3天入院。患者3天天前突然开始出现剧烈呕吐，呕吐物逐渐出现咖啡色和鲜红色，间断腹痛，解稀便十余次，小便逐渐减少，并出现双下肢浮肿。入院后完善相关检查，其中血汞6000nmol/l!虽然没有明显水银接触史和被投毒史，以及被明确诊断为急性汞中毒；急性肾功能衰竭。予以血液透析等处理，35天后好转出院。
5、9个月孪生兄妹，先后三小时内出现咳嗽、气喘、呼吸困难、四肢抽动。入院第三天后哥哥经抢救无效死亡，妹妹一周后好转出院。同样都被诊断为：急性汞蒸气中毒。原来发病前孪生兄妹在家中睡觉，爸爸在家中熏汞炼金！
6、34岁女性患者，为某商场销售人员。2个月前开始间断在使用某品牌美白的日霜、晚霜。逐渐出现腰痛、少尿、乏力、浮肿、多汗。入院后考虑诊断为汞中毒。检测该品牌的日霜、晚霜中汞含量均严重超标！
7、48岁农村主妇，因为“脱发，头皮生疮三月”在当地某中医处治疗，先后口服中药二月，外用该中医自制药物十日。逐渐出现口腔出血、下肢浮肿、反复发热、多汗心悸，又至当地社区卫生服务中心诊治，误诊为风湿相关性疾病。入院三天后病情加重，遂转院。后来证实为急性汞中毒，抢救无效死亡！
类似的病例有很多。对于这些急性汞中毒来说，常见的主要临床表现主要有：
1、消化道症状：可以出现恶心、呕吐、腹痛、腹泻、血便等症状。
2、口腔病变：可以出现口腔溃疡、牙龈出血、牙齿松动等。
3、神经系统:会出现头晕、头痛、失眠、乏力、震颤、昏迷等。
4、泌尿系统：会有腰痛、少尿或无尿、下肢或全身浮肿等急性肾功能衰竭症状。
5、呼吸系统 ：咳嗽、胸闷、气短、呼吸困难、胸痛、晕厥等。
6、血液系统：可以出现血小板减少，也可以诱发再生障碍性贫血。
在王汉斌、牛文凯所著《汞中毒的诊断与治疗》中对于汞中毒的具体机制有如下描述：
“汞蒸气由呼吸道吸收，金属汞由消化道吸收量比较少，约是摄食量的万分之一，汞盐在消化道的吸收量约10%。汞盐也可以由皮肤、粘膜吸收。
金属汞和一价汞化合物进入血液后，在血内可氧化成二价汞离子，后者与血浆蛋白、血红蛋白结合，形成蛋白结合型汞。汞还可以与体液中阴离子结合，也可以与含巯基的低分子化合物，如半胱氨酸、还原型谷胱甘肽结合，形成扩散性汞。这两种汞随血液分布于各组织器官，其中以肾含量最高。汞蒸气吸入后，可通过血脑屏障进入脑内！
汞时许多酶的非特异性抑制剂。汞离子对巯基、二巯基具有高度亲和力，使体内具有重要生物活性的与巯基有关的酶，如细胞色素氧化酶、琥珀酸脱氢酶等失去活性；汞还与氨基、羧基、磷酰基结合而影响功能基因的活性。
由于这些酶和功能基因活性受影响，阻碍了细胞的生物活性和正常代谢，最终导致细胞坏死和变性，从而引起中枢和植物神经系统功能紊乱、肾脏等脏器损害。”
如果怀疑为急性汞中毒该如何处理？
1、立即脱离现场，切勿擅自用药！
2、尽早就医，尽早洗胃、导泻（有胃出血者慎重洗胃，且勿用生理盐水洗胃）
3、驱汞治疗：二巯丙磺钠、青霉胺、二巯丙醇、二巯丁二钠等。这些药物中以二巯丙磺钠为首选。这种重金属螯合剂，可以取代巯基团中的汞离子，形成汞复合物从尿中排除，达到驱汞治疗的目的！
4、其它对症治疗。
虽然水银中毒会给身体带来很大危害而且预期很差，但是我们没有必要杯弓蛇影。因为生活中我们很少能够直接暴露在水银之中，而且能够接触的量很少。
但是，有一点很重要：
要慎重使用中药，尤其是那些含有汞或者成分不明的中药物！