• Rezultati Niso Bili Najdeni

Pdf_datoteka

N/A
N/A
Protected

Academic year: 2022

Share "Pdf_datoteka"

Copied!
5
0
0

Celotno besedilo

(1)

6ORY3HGLDWU

3UHJOHGQLþODQHN5HYLHZDUWLFOH

ZASTRUPITEV Z OGLJIKOVIM MONOKSIDOM CARBON MONOXIDE POISONING

=.RURãHF1Rþ-%RãQMDN

(1) Osnovno zdravstvo Gorenjske, Zdravstveni dom Jesenice, Jesenice, Slovenija (2) Zdravstveni dom Novo mesto, Novo mesto, Slovenija

,=9/(ý(.

=DVWUXSLWHY ] RJOMLNRYLP PRQRNVLGRP &2 MH QDMEROM UD]ãLUMHQDQHQDPHUQD ]DVWUXSLWHY GR NDWHUH QDMSR- JRVWHMHSULGH]DUDGLVODERY]GUåHYDQLKDOLQDPHãþHQLKJUHOQLKWHOHVY]DSUWLKSURVWRULK&2SUHNRãWHYLOQLK SDWR¿]LRORãNLK PHKDQL]PRY SRY]URþL WNLYQR KLSRNVLMR LQ RNYDUR WNLY V VLPSWRPL LQ ]QDNL SRYH]DQLPL ] ]DVWUXSLWYLMR 7L VR SUL EODåML REOLNL ]DVSDQRVW JODYRERO VODERVW LQ XWUXMHQRVW SUL KXMãL SD KXG JODYRERO VODERVWEUXKDQMHQHYURORãNHPRWQMHPRWQMHVUþQHJDULWPDLQLVKHPLMDPLRNDUGD=QDNLVR SULRWURFLKãH EROMQHVSHFL¿þQLLQSULNULWL3R]QDPRWXGLNURQLþQRREOLNR]DVWUXSLWYHPRåQHSDVRWXGLSR]QHQHYURORãNH SRVOHGLFH3RPHPEQRMHGDRE]DVWUXSLWYLþLPSUHMXNUHSDPR]DVWUXSOMHQFDRGVWUDQLPRL]QHYDUQHJDRNROMD JD VSUHMPHPR Y EROQLãQLFR WHU RSUDYLPR RVQRYQR LQ GRGDWQR GLDJQRVWLFLUDQMH LQ RSD]RYDQMH =GUDYOMHQMH ]DþQHPRVþLPSUHMãQMLPGRYDMDQMHPNLVLNDSULKXMãL]DVWUXSLWYLSDEROQLND]GUDYLPRVSRPRþMRKL- SHUEDULþQHNRPRUH96ORYHQLMLMHWRYUVWQR]GUDYOMHQMHXUHMHQRSUHNR&HQWUD]D]DVWUXSLWYH8.&/MXEOMDQD NLLPDXUHMHQRVWDOQRSULSUDYOMHQRVW3RPHPEQRMHGDMDYQRVWVH]QDQLPR]QHYDUQRVWPL]DVWUXSLWYHV&2LQ ]XNUHSL]DQMHQRSUHSUHþHYDQMH

.OMXþQHEHVHGHRJOMLNRYPRQRNVLG]DVWUXSLWHYKLSHUEDULþQDNRPRUD

ABSTRACT

&DUERQ PRQR[LGH &2 SRLVRQLQJ LV WKH PRVW IUHTXHQW DFFLGHQWDO SRLVRQLQJ ZKLFK LV XVXDOO\ FDXVHG E\

SRRUPDLQWHQDQFHRULQVWDOODWLRQRIKHDWHUVLQHQFORVHGVSDFHV&2FDXVHVWLVVXHK\SR[LDDQGGHJUDGDWLRQ E\PDQ\SDWKRSK\VLRORJLFDOPHFKDQLVPV6\PSWRPVDQGVLJQVDUHDGLUHFWFRQVHTXHQFHRIWKHSRLVRQLQJ,Q PLOGHUSRLVRQLQJSDWLHQWVH[SHULHQFHGURZVLQHVVKHDGDFKHQDXVHDDQGIDWLJXH,QPRUHVHYHUHSRLVRQLQJWKH V\PSWRPVDUHVHYHUHKHDGDFKHQDXVHDYRPLWLQJQHXURORJLFDOGLVWXUEDQFHVKHDUWUK\WKPGLVWXUEDQFHVDQG P\RFDUGLDOLVFKDHPLD,QFKLOGUHQWKHVLJQVDUHHYHQPRUHQRQVSHFL¿FDQGKLGGHQ&KURQLFSRLVRQLQJDQG ODWHQHXURORJLFDOVHTXHODHDUHDOVRSRVVLEOH,WLVLPSRUWDQWWRLPPHGLDWHO\UHPRYHSHRSOHIURPWKHGDQJHU- RXVDUHDDQGWUDQVSRUWWKHPWRKRVSLWDOIRUGLDJQRVWLFZRUNXSDQGREVHUYDWLRQ7KHWUHDWPHQWRIFKRLFHLV R[\JHQZKLOHPRUHVHYHUHSRLVRQLQJLVWUHDWHGZLWKK\SHUEDULFR[\JHQWKHUDS\,Q6ORYHQLDWKLVLV

(2)

DYDLODEOHWKURXJKWKH3RLVRQV&HQWUH8QLYHUVLW\&OLQLFDO&HQWUH/MXEOMDQDZKLFKKDVRQFDOOWR[LFRORJLVWV and engineers. Public education on the dangers of CO poisoning and measures for its prevention is important.

.H\ZRUGV&DUERQPRQR[LGHSRLVRQLQJK\SHUEDULFR[\JHQWKHUDS\

UVOD

2JOMLNRYPRQRNVLG&2MHSOLQEUH]EDUYHYRQMDLQ RNXVD 1DVWDMD SUL QHSRSROQHP L]JRUHYDQMX VQRYL NLYVHEXMHMRRJOMLNOHVSUHPRJQDIWDNXULOQRROMH EHQFLQSURSDQEXWDQ-HQDMSRJRVWHMãLY]URNVPUWL ]DUDGL QHQDPHUQH ]DVWUXSLWYH 9 6ORYHQLML MH Y REGREMXí]DUDGLQHQDPHUQH]DVWUXSLWYHV

&2XPUOROMXGLNDUMHSULEOLåQRVPUWLQDOHWR

&2YELYDOQLKSURVWRULKQDMSRJRVWHMHQDVWDMD]D- UDGLQHSUDYLOQHQDPHVWLWYHYJUDGQMHGHORYDQMDDOL Y]GUåHYDQMDSHþLQDWUGDJRULYDNDPLQRYSOLQVNLK gorilnikov za ogrevanje prostorov in vode ter zaradi VODERY]GUåHYDQLKGLPQLNRY

6WRSQMD]DVWUXSLWYHMHRGYLVQDRGWHOHVQHGHMDYQRVWL trajanja izpostavljenosti ter relativnih koncentracij

&2LQNLVLND%ODJH]DVWUXSLWYHQHSRY]URþDMRVSH- FL¿þQLK]QDNRYDOLVLPSWRPRY]DWRMLKSRJRVWRSUH- ]UHPR %ODJD ]DVWUXSLWHY MH SRGREQD JULSL EROQLN WRåL]DJODYRERORPMHXWUXMHQLQEUH]PRþL2WURFL LPDMRSRJRVWRWXGLSUHEDYQHWHåDYH

PATOFIZIOLOGIJA

&2 ] YGLKDQLP ]UDNRP SUHNR SOMXþ SUHKDMD Y NUL NMHUVH]NUDWYHþMRD¿QLWHWRNRWNLVLN2YHåH QD KHPRJORELQ +E LQ WYRUL NDUERNVLKHPRJORELQ

&2+E1MHJRYRWRNVLþQRGHORYDQMHSRWHNDSUHNR UD]OLþQLKPHKDQL]PRY

=DUDGLYHþMHD¿QLWHWH]DYH]DYRQDKHPRJORELQ ]PDQMãD]PRJOMLYRVWNUYL]DSUHQRVNLVLNDNDU SRY]URþL UHODWLYQR DQHPLMR V SRVOHGLþQR KLSR- ksijo.

9WNLYLK]DYLUDVSURãþDQMHNLVLNDL]KHPRJOREL- QDNDUSRY]URþDSRPLNGLVRFLDFLMVNHNULYXOMHY OHYRLQWDNRãHGRGDWQRSRVODEãDWNLYQRKLSRNVL- jo.

9HåH VH QD HQFLPH GLKDOQH YHULJH FLWRNURP RNVLGD]RLQ3YWNLYLKLQVWHPQHSRVUHGQR vpliva na tkivno hipoksijo.

9HåH VH QD PLRJORELQ VNHOHWQLK PLãLF LQ PLR- NDUGDNDUSRY]URþLPLãLþQRRVODEHORVWPRWQMH koordinacije in ishemijo miokarda.

3RY]URþD SHURNVLGDFLMR OLSLGRY LQ ] OHYNRFLWL SRVUHGRYDQH YQHWQH SURFHVH Y PRåJDQLK NDU YRGLYGHPLHQLOL]DFLMRHGHPLQåDULãþQRQHNUR- ]RSUHGYVHPYSUHGHOXglobus pallidus.

&2VHL]RUJDQL]PDL]ORþDSUHNRSOMXþ5D]SRORYQL þDV +E&2 SUL YGLKDYDQMX DWPRVIHUVNHJD ]UDND MH

±XURGVWRWQLNLVLNSULDWPRVIHUVNHPWODNXL]- SRGULYD&2V&2+EYNUYLLQUD]SRORYQLþDVVNUDMãD QD±PLQXW9GLKDYDQMHRGVWRWQHJDNLVLND YKLSHUEDULþQLNRPRULSULWODNX±DWPSDRPRJRþL L]ORþDQMH&2NLMHYH]DQQDHQFLPHGLKDOQHYHULJH LQVNUDMãDUD]SRORYQLþDVQD±PLQXW

./,1,ý1$6/,.$

.OLQLþQDVOLNDQLRGYLVQDRGNRQFHQWUDFLMH&2+EY NUYLDPSDNSUHGYVHPRGNRQFHQWUDFLMH&2Y]UD- NX WUDMDQMD L]SRVWDYOMHQRVWL WHOHVQH GHMDYQRVWL Y þDVXL]SRVWDYOMHQRVWLLQNRQFHQWUDFLMHKHPRJORELQD Y NUYL 7HåDYH VH SRMDYOMDMR SUL NRQFHQWUD- FLML SUL NRQFHQWUDFLML ± SD QDVWRSLMR NRQYXO]LMHNRPDLQVPUW=QDNL]DVWUXSLWYHVR QHVSHFL¿þQL]DWRMLK]HORSRJRVWRVSUHJOHGDPR0

%UYDUHWDOVRYUHWURVSHNWLYQLUD]LVNDYLYNDWHURVR ELOLYNOMXþHQLEROQLNLKRVSLWDOL]LUDQL]DUDGL]DVWUX- SLWYHV&2Y&HQWUX]D]DVWUXSLWYH&=LQ&HQWUX LQWHQ]LYQH LQWHUQH PHGLFLQH &,,0 Y .OLQLþQHP FHQWUXY/MXEOMDQLYREGREMXíXJRWRYLO da je incidenca neletalnih zastrupitev v Ljubljan- VNLUHJLMLNUDWQLåMDNRWYVYHWX1DMSRPHPEQHMãL Y]URNWDNRQL]NHSRMDYQRVWLMHSUHGYVHPGHMVWYRGD

(3)

]DVWUXSLWHYV&2SRJRVWRQHSUHSR]QDPR%ODJD ]DVWUXSLWHY VH NDåH QDPUHþ ] ]QDNL NL VR SRGREQL JULSLEODJGR]PHUHQJODYREROVODERVWXWUXMHQRVW RPRWLFD RVODEHORVW LQ EUXKDQMH +XMãH ]DVWUXSLWYH VHNDåHMRVKXGLPJODYRERORPVODERVWMR]EUXKD- QMHP PRWQMDPL YLGD PRWQMDPL VSRPLQD LQ NRQ- FHQWUDFLMH]DVSDQRVWMR]PHGHQRVWMRVWHåDYDPLSUL PLãOMHQMXSDUHVWH]LMDPL]DWDNVLMRPRWQMDPLVUþQH- JD ULWPD LVKHPLMR PLRNDUGD ODKNR SD VH RGUD]LMR WXGL ] DNXWQLP PLRNDUGQLP LQIDUNWRP $0, 3UL izpostavljenosti zelo visokim koncentracijam CO se SRMDYLMRNRQYXO]LMHLQNRPDVPUWSDQDVWRSL]DUDGL PRåJDQVNHJDHGHPDDOLVUþQHJD]DVWRMDNLMHSRVOH- GLFDLVKHPLMHPLRNDUGD

3UL RWURFLK VR ]QDNL ãH EROM QHVSHFL¿þQL LQ SULNUL- WL VDM RWURFL WHåDY QDYDGQR WXGL QH ]QDMR XVWUH]QR RSLVDWL3RJRVWRSUHYODGXMHMRSUHEDYQHWHåDYHEUX- KDQMH GULVND EROHþLQH Y WUHEXKX ]DVSDQRVW JODYRERO]DQDãDQMHSULKRMLQHQDWDQþQLJLELSRVSH- ãHQRGLKDQMHNUþLODKNRSDMHSUYLVLPSWRPVLQNRSD 7HåDYHVHSULRWURFLK]DUDGLYHþMHSRUDEHNLVLND Y WNLYLK LQ YHþMH PLQXWQH YHQWLODFLMH SRMDYLMR SUL QLåMLKNRQFHQWUDFLMDK&2+EYNUYLNRWSULRGUDVOLK PHGWHPNRMHRNUHYDQMHKLWUHMãH3ULPODGRVWQL- kih zastrupitev poteka podobno kot pri odraslih.

3ULNOLQLþQHPSUHJOHGXVRSULVRWQL]QDNLNRWVRWDKL- NDUGLMDWDKLSQHMDLQKLSHUWHUPLMD.RåDMHSULEODåML ]DVWUXSLWYLEOHGDDOLFLDQRWLþQDODKNRPDUPRULUDQD WLSLþQRþHãQMHYRUGHþHREDUYDQMHNRåHSDVHSRMDYL SUL ]HOR KXGLK ]DVWUXSLWYDK LQ VH RELþDMQR SRNDåH ãHOH SR VPUWL 0RWQMH ]DYHVWL VR ODKNR UD]OLþ- QLK VWRSHQM ]PHGHQRVW OHWDUJLMD VWXSRU NRPD 9 QHYURORãNHP VWDWXVX ODKNR XJRWDYOMDPR PRWQMH NRRUGLQDFLMHDSUDNVLMRDJQR]LMRWLNHPRWQMHYLGD LQVOXKDPRWQMHVSRPLQDDQWHURJUDGQDLQUHWURJUD- GQDDPQH]LMDþXVWYHQRQHVWDELOQRVWLQNRJQLWLYQH PRWQMH = RIWDOPRORãNLP SUHJOHGRP XJRWDYOMDPR PUHåQLþQHNUYDYLWYHYREOLNLSODPHQDVYHWORUGHþH PUHåQLþQHYHQHSDSLORHGHPLQKRPRQLPQRKHPL- DQRSVLMR6YHWORUGHþHREDUYDQMHPUHåQLþQLKYHQMH ]HORREþXWOMLY]JRGQML]QDN6SUHPHPEHQDPUH- åQLFL LQ UGHþH REDUYDQMH NRåH VWD HGLQD VSHFL¿þQD znaka zastrupitve s CO.

.URQLþQD]DVWUXSLWHYVHSRMDYLSRGROJRWUDMQLL]SR- VWDYOMHQRVWLQL]NLPNRQFHQWUDFLMDP&27UDMDGOMH ODKNRPHGYVRNXULOQRVH]RQR=QDNLNURQLþQH]D- VWUXSLWYHVRSRJRVWLJODYREROLLQVSORãQRVODERSR- þXWMHNLMHSRGREQRYLUR]LPRWQMHNRQFHQWUDFLMHLQ VSDQMDWHUQHVSHFL¿þQHXþQHWHåDYH

3R]QH QHYURORãNH SRVOHGLFH VH SRMDYLMR SUL ± RWURNY±GQHKSR]DVWUXSLWYL.DåHMRVH NRWNURQLþQLJODYREROHSLOHSVLMDSDUH]DREUD]QHJD åLYFD PRWQMH VSRPLQD SVLKRPRWRULþQL ]DRVWDQHN SVLKR]DWHULQNRQWLQHQFDEODWDLQXULQD3RJRVWH- MHQDVWDQHMRSULVWDURVWQLNLKLQSRGDOMþDVDWUDMDMRþL KLSRNVLML3RHQLL]PHGãWXGLMVHVWDQMHSULERO- QLNRYL]EROMãDYHQHPOHWX

./,1,ý1$2%5$91$9$

1DWHUHQX]DVWUXSOMHQFDNDUVHGDKLWURRGVWUDQLPR L]QHYDUQHJDRNROMDLQPXRPRJRþLPRYGLKDYDQMH RGVWRWQHJD NLVLND ýH XJRWRYLPR PRWQMH ]D- YHVWL EROQLND þLP SUHM LQWXELUDPR LQ QDGDOMXMHPR SUHGLKDYDQMH V NLVLNRP 1DG]LUDPR YLWDOQH IXQN- FLMHXWULSNUYQLWODN(.*3XO]QDRNVLPHWULMDQL primerna metoda za oceno koncentracije COHb.

2ELþDMQRMHQDVLþHQRVWNUYLVNLVLNRPNOMXEFLDQR]L Y QRUPDOQHP REPRþMX =D GRORþDQMH NRQFHQWUDFL- je COHb je tako najbolj zanesljiva plinska analiza DUWHULMVNH NUYL 3$$. R] YHQVNH NUYL 3$9.

NL SRNDåH ]YLãDQR NRQFHQWUDFLMR &2+E ! normalno vrednost pO]QLåDQRYUHGQRVW+E2 in ]QDNHPHWDEROQHDFLGR]H]YLãDQRYUHGQRVWODNWDWD ]QLåDQSUHVHåHNED]

9QDGDOMQMLREUDYQDYLPRUDPRRSUDYLWLãHGRGDWQH SUHLVNDYHLQGRORþLWLKHPRJUDPYUHGQRVWHOHNWUROL- WRYNUYQHJDVODGNRUMDGXãLþQLKUHWHQWRYOHGYLþQD RGSRYHG]DUDGLUDEGRPLROL]HLQWUDQVDPLQD]SUH- JOHGDWLPRUDPRWXGLXULQWHUGRORþLWL&.LQPLRJOR- ELQYXULQXUDEGRPLROL]D2SUDYLPRWXGLWRNVLNR- ORãNHSUHLVNDYHDONRKROGURJHFLDQLGSULVXPXQD ]DVWUXSLWHY]GLPRPLQGRORþLPRGHOHåPHWKHPR- globina.

(4)

6SHPOMDPR WXGL (.* ]DUDGL SRJRVWH SULVRWQRVWL VLQXVQH WDKLNDUGLMH PRWHQM VUþQHJD ULWPD SUL KX- GLK]DVWUXSLWYDKSDWXGLLVKHPLþQLKVSUHPHPE3UL VUþQLK EROQLNLK ODKNR åH ]HOR QL]NH NRQFHQWUDFLMH SRY]URþLMRKXGRSRVODEãDQMHRVQRYQHEROH]QL5HQW- JHQRJUDP SUVQLK RUJDQRY MH ODKNR QRUPDOHQ EUH]

SDWRORãNLK VSUHPHPE 3ULVRWQRVW SHULKLODUQLK VHQF SHULEURQKLDOQLK LQ SHULYDVNXODUQLK LQ¿OWUDWRY ter intraalevolnega edema pomenijo slabo napoved L]LGDEROH]QL9SULPHUXKXGLKQHYURORãNLKPR- WHQMPRUDPR]DL]NOMXþLWHYGUXJLKY]URNRYRSUDYLWL WXGL XVWUH]QR VOLNRYQR GLDJQRVWLFLUDQMH &7 05 JODYH1DMSRJRVWHMHXJRWDYOMDPRVRKLSRGHQ]QH VSUHPHPEHYSRGURþMXglobus pallidus in bazalnih JDQJOLMLKWHUGLIX]QLPRåJDQVNLHGHP2SLVXMHMRVR WXGLSULPHUHKLGURFHIDOXVD

ZDRAVLJENJE

=GUDYLPR]GRYDMDQMHPRGVWRWQHJDNLVLNDGR- kler bolnik ni brez simptomov oz. dokler koncentra- FLMD&2+EQHSDGHSRG7UDMDQMH]GUDYOMHQMD RFHQLPRJOHGHQDL]KRGLãþQRNRQFHQWUDFLMR&2+E SULþHPHUXSRãWHYDPRUD]SRORYQLþDVNL]QDãD±

PLQXW%ROQLNDODKNRRGSXVWLPRYGRPDþRRVNU- ERNRMHEUH]VLPSWRPRYLQMHNRQFHQWUDFLMD&2+E QRUPDOQDSRGYHGQRSDVHWXGLSUHSULþDPR GDMHYUQLWHYYGRPDþHRNROMHYDUQD9QDVOHGQMLK

±WHGQLKRGVYHWXMHPRYVDNUãQRWHOHVQRXGHMVWYR- YDQMH

Pri hudih zastrupitvah je indicirano zdravljenje v KLSHUEDULþQL NRPRUL 1D WD QDþLQ ] YGLKDYDQMHP RGVWRWQHJDNLVLNDSULWODNX±DWPVNUDMãDPR UD]SRORYQLþDV&2+EQD±PLQXW

,QGLNDFLMH ]D ]GUDYOMHQMH Y KLSHUEDULþQL NRPRUL VR

±

• koncentracija COHb v arterijski ali venski krvi

•

• SULQRVHþQLFDKNRQFHQWUDFLMD&2+E•

• VWDURVW ” PHVHFHY RE SULVRWQRVWL VLPSWRPRY UD]GUDåOMLYRVWOHWDUJLMDWHåDYHSULKUDQMHQMX

• PRWQMH]DYHVWLQHJOHGHQDNRQFHQWUDFLMR&2+E

• QHYURORãNH PRWQMH QH JOHGH QD NRQFHQWUDFLMR

&2+E

• Y]WUDMDQMHQHYURORãNLKPRWHQMWUHPRUSDUHVWH- ]LMHSDUH]HNRQYXO]LMHSRXUDK]GUDYOMHQMD VNLVLNRP

• PRWQMH VUþQHJD ULWPD (.* ] ]QDNL LVKHPLMH PLRNDUGDDOLVVWHQRNDUGLMR

• KXGDPHWDEROQDDFLGR]DS+

96ORYHQLMLMHKLSHUEDULþQDNRPRUDQDYROMRQDOMX- EOMDQVNL0HGLFLQVNLIDNXOWHWL=D]GUDYOMHQMHMHSR- WUHEQRVWRSLWLYVWLN]GHåXUQLPWRNVLNRORJRP8.&

/MXEOMDQDWHOHIRQVNDãWHYLONDNLRG- redi zdravljenje in uredi premestitev bolnika. Pri ne- zavestnih bolnikih in majhnih otrocih moramo pred ]DþHWNRP]GUDYOMHQMDRSUDYLWLãHWLPSDQRFHQWH]RLQ se o postopku posvetovati tudi s specialistom ORL.

=DSOHWH]DVWUXSLWYHV&2WMPRåJDQVNLHGHPNRQ- YXO]LMH $0, OHGYLþQR RGSRYHG LSG ]GUDYLPR simptomatsko.

=$./-8ý(.

=DVWUXSLWHY]RJOMLNRYLPPRQRNVLGRPMHHQDQDMSR- JRVWHMãLK]DVWUXSLWHYãHSRVHEQRY]LPVNLKPHVHFLK 9HOLNR]DVWUXSLWHYVH]JRGLQHQDPHUQR.OLQLþQDVOL- NDLQ]QDNL]DVWUXSLWYHVRSRJRVWRQHVSHFL¿þQLLQVR ODKNRSRVOHGLFDDNXWQHDOLNURQLþQH]DVWUXSLWYH2E WHåNLDNXWQL]DVWUXSLWYLVHODKNRSRMDYLMRWXGLSR]QH SRVOHGLFHNLVRSUHGYVHPQHYURORãNH2EVWLNX]D- VWUXSOMHQFDYHGQRþLPSUHMRGVWUDQLPRL]QHYDUQHJD RNROMDLQPXWDNRMGRYDMDPRRGVWRWQLNLVLNNLMH tudi zdravljenje izbire pri vseh starostnih skupinah.

%ROQLN YHGQR SRWUHEXMH EROQLãQLþQR REUDYQDYR ] ODERUDWRULMVNRIXQNFLRQDOQRLQYþDVLKWXGLVOLNRYQR GLDJQRVWLNR=ODWLVWDQGDUGMHSOLQVNDDQDOL]DNUYL]

oksimetrijo. Razvijajo tudi naprstne merilce COHb.

ýHVRL]SROQMHQDPHULOD]D]GUDYOMHQMHYKLSHUEDULþQL NRPRULWRYUVWQR]GUDYOMHQMHY6ORYHQLMLL]YDMDPRQD ljubljanski Medicinski fakulteti po dogovoru z de- åXUQLP WRNVLNRORJRP 8.& /MXEOMDQD 3UL RWURFLK PRUDPRYþDVLKRSUDYLWLWLPSDQRFHQWH]RSRSRVYHWX VVSHFLDOLVWRP25/GHåXUQLP3ROHJKLWUHJDLQSUD-

(5)

YLOQHJDXNUHSDQMDRE]DVWUXSLWYLMH]HORSRPHPEQR GDRQHYDUQRVWL]DVWUXSLWHYV&2RVYHãþDPRMDYQRVW LQWDNRþLPYHþ]DVWUXSLWHYWXGLSUHSUHþLPR

LITERATURA

0RåLQD0=DVWUXSLWYH,Q.RFLMDQþLþ$0UH- YOMH)HGV,QWHUQDPHGLFLQDQGHG/MXEOMDQD /LWWHUDSLFWD

'RVHJOMLYRQDKWWSZZZLY]VL

0SDVS["QL SL BBLG BB 3DJH,QGH[ BBJURXS,G BB QHZV&DWHJRU\ ,9=NDWHJRULMD BB DFWLRQ 6KRZ1HZV)XOO SO

%UYDU 0 -DPãHN 0 0RåLQD 0 +RUYDW 0

*RUMXS9(SLGHPLRORãNLSUHJOHG]DVWUXSLWHY]

RJOMLNRYLPPRQRNVLGRPY/MXEOMDQLRGGR

=GUDY9HVWQ

6KRFKDW*17DUDEDU$&DUERQPRQR[LGHWR[L- FLW\LQHPHUJHQF\PHGLFLQHFOLQLFDOSUHVHQWDWL- on. Dosegljivo na: http://emedicine.medscape.

FRPDUWLFOH

5RGJHUV*&&RQGXUDFKH75HHG0'%HVWLF 0*DO33RLVRQLQJV,Q.OLHJPDQ50%HKU- PDQ5(-HQVRQ+%6WDQWRQ%)HGV1HOVRQ 7H[WERRN RI 3HGLDWULFV WK HG 3KLODGHOSKLD :%6DXQGHUV&RPSDQ\

<DUDU & 1HXURORJLFDO HIIHFWV RI DFXWH FDUERQ PRQR[LGH&2SRLVRQLQJLQFKLOGUHQ-3HGLDWU 6FLH

6RQH6+LJDVKLKDUD7.RWDNH70RULPRWR6 0LXUD72JDZD0HWDO3XOPRQDU\PDQLIHVWD- WLRQVLQDFXWHFDUERQPRQR[LGHSRLVRQLQJ$P -5HQWJHQRO

*UDQW 0-& &OD\ % DFFLGHQWDO FDUERQ PR- QR[LGH SRLVRQLQJ ZLWK VHYHUH FDUGLRUHVSLUDWR- U\FRPSURPLVHLQFKLOGUHQ$P-&ULW&DUH

+DUG\.57KRP653DWKRSK\VLRORJ\DQGWUH- DWPHQWRIFDUERQPRQR[LGHSRLVRQLQJ-7R[L- FRO&OLQ7R[LFRO

&KRL ,6 'HOD\HG QHXURORJLF VHTXHODH LQ FDU- ERQPRQR[LGHLQWR[LFDWLRQ$UFK1HXURO

.RQWDNWQDRVHED&RQWDFWSHUVRQ

=DOD.RURãHF1RþGUPHG Osnovno zdravstvo Gorenjske

=GUDYVWYHQLGRP-HVHQLFH 6,-HVHQLFH

6ORYHQLMD

3ULVSHOR5HFHLYHG 6SUHMHWR$FFHSWHG

Reference

POVEZANI DOKUMENTI

3RGUXJLVWUDQLVRIHGHUDOLVWLáQRRSFLMR PRáQR SRG SUOD HYURSVND IHGHUDOLVWLáQD JLEDQMD NL VR SUHGODJDOD SUHQRV GHOD L]YUÊLOQLK QDORJ RG .RPLVLMH LQ 6YHWD PL QLVWURY QD SDUODPHQW Y

'R VSRPODGL MH LPHOD (GLQRVW ÊH QHNDM ]ER URYDQM NL VR ELOD SRVYHáHQD SUHGYVHP ÊROVNLP YSUDÊD QMHPPDMDSDMHELORY3D]LQXÌHXVWDQRYOMHQR 3ROLWLáQR GUXÊWYR ]D +UYDWH LQ 6ORYHQFH Y ,VWUL

2QNRORãNR ]GUDYOMHQMH SRãNRGXMH WXGL ]GUDYD WNL- YDSUHGYVHPVOX]QLFRXVWLQSUHEDYLONDUSUDYWDNR SRY]URþD KXGH EROHþLQH 2WURFL NL VH ]GUDYLMR V NRUWLNRVWHURLGL LPDMR SRJRVWR EROHþLQH

9VDND ]DVWUXSLWHY Y YHþLQL SULPHURY ]DKWHYD WXGL SRVYHW ] GUåDYQLP &amp;HQWURP ]D ]DVWUXSLWYH DOL GHåXUQLP WRNVLNRORJRP 2EYH]QR SD MH SRWUHEQR ]DVWUXSLWHY WXGL SULMDYLWL Y

=DVWUXSLWYH SUL RWURFLK VR YHOLN ]GUDYVWYHQL SUR- blem. Otroci pridejo v stik s strupom zaradi ra-

9HþLQD WHK RWURN QL VDPRVWRMQLK LQ SRWUHEXMHMR SRSROQR SRPRþ LQ RVNUER &amp;HORVWQD REUDYQDYD RWURND]JDVWURVWRPRQH]DMHPDOHSRJRYRUDVVWDUãL

3VLKRVRFLDOQD SULODJRGLWHY QD NURQLþQR EROH]HQ MH NRQWLQXLUDQ GROJRWUDMHQ NRPSOHNVHQ LQ QHSUHG- YLGOMLY SURFHV 3UL RWURFLK V NURQLþQR EROH]QLMR LQ QMLKRYLK GUXåLQDK VR SULVRWQD

3UL EROQLNLK V KHPR¿OLMR VR SRJRVWH WXGL PDQMãH NUYDYLWYH 3RGNRåQH NUYDYLWYH VH VþDVRPD VDPH UHVRUELUDMR ]DWR QDGRPHVWQR ]GUDYOMHQMH QL SRWUHEQR 'UXJH PDQMãH NUYDYLWYH VR ãH