Tau ntev, phthalates yog thawj cov yas siv los tsim cov khoom siv kho mob kom muag PVC. Txawm li cas los xij, feem ntau ntawm cov neeg siv khoom siv kho mob yog cov neeg tsis muaj zog, thiab raug rau cov khoom tsim kev puas tsuaj yuav ua rau muaj kev pheej hmoo rau lawv txoj kev noj qab haus huv.
Thaum Lub Xya Hli 12, 2002, US FDA tau tshaj tawm ib daim ntawv qhia 119- nplooj ntawv txheeb xyuas kev nyab xeeb ntawm DEHP-plasticized PVC cov khoom siv kho mob. Daim ntawv tshaj tawm tau sau tseg tias thaum txhua tus neeg raug DEHP txhua hnub, qee tus neeg, vim muaj kev kho mob, tej zaum yuav raug DEHP ntau dua. DEHP tuaj yeem nkag mus rau hauv cov kev daws teeb meem uas tuaj yeem sib cuag nrog cov cuab yeej kho mob, nrog cov nyiaj leached nyob ntawm qhov kub thiab txias, cov ntsiab lus lipid ntawm cov kua, thiab lub sijhawm sib cuag. Cov neeg mob uas muaj mob hnyav, xav tau ntau yam kev kho mob, muaj kev pheej hmoo ntawm DEHP ntau dua.
Ib yam li ntawd, thaum Lub Kaum Hli 31, 2002, Nyiv Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv, Kev Ua Haujlwm, thiab Kev Noj Qab Haus Huv tau tshaj tawm Daim Ntawv Ceeb Toom No. Daim ntawv tshaj tawm qhia cov kws kho mob kom tsis txhob siv DEHP-muaj cov khoom siv kho mob PVC thiab xaiv cov khoom siv lwm yam. DEHP yog suav hais tias yog ib qho tshuaj lom neeg uas muaj kev phom sij rau tib neeg cov ntshav. Qhov pom tau txhua hnub (ADI) rau DEHP yog nyob nruab nrab ntawm 40 txog 140 mg / kg. Kev ntsuam xyuas tau pom tias cov hnab ntshav thiab lub plawv-lub ntsws tshuab dhau qhov kev txwv no, ua rau muaj kev pheej hmoo loj.
Loj-Volume Parenteral Solutions
Loj-ntim parenteral (LVP) cov kev daws teeb meem yog qhov tseem ceeb hauv kev kho mob, xa cov tshuaj sai sai rau cov neeg mob, ntxiv cov as-ham, thiab tswj cov electrolyte thiab acid-base tshuav nyiaj li cas hauv lub cev, tshwj xeeb tshaj yog hauv kev kho mob tseem ceeb. Muab cov tshuaj LVP ncaj qha mus rau hauv tus neeg mob cov hlab ntsha, lawv suav tias yog cov tshuaj uas muaj kev pheej hmoo siab.
Cov ntaub ntawv ntim khoom yuav tsum tiv thaiv cov tshuaj los ntawm ib puag ncig ib puag ncig los txhawb kev khaws cia, kev thauj mus los, muag, thiab siv. PVC, ua ib qho kev tsim kho thaum ntxov, kev paub tab, thiab cov khoom siv tau zoo, yog siv dav. Txawm li cas los xij, thaum ua tiav, cov khoom ntxiv xws li di ({2}}ethylhexyl) phthalate (DEHP) plasticizers thiab cov nplaum ntxiv. Thaum lub sijhawm tsim khoom, khaws cia, tsheb thauj mus los, muag, thiab siv cov tshuaj LVP, kev sib cuam tshuam ntawm cov tshuaj thiab cov khoom ntim tuaj yeem ua rau cov khoom txav ntawm lub ntim rau hauv cov tshuaj, uas yuav ua rau muaj kev cuam tshuam tsis zoo ib zaug hauv lub cev.
Neonatal Parenteral Nutrition Txhaj Tshuaj
Neonatal parenteral kev daws teeb meem feem ntau yog npaj los ntawm kev ntxiv cov khoom tsim nyog, suav nrog lipid emulsions, rau hauv 10% qabzib txhaj tshuaj PVC hnab mos. Raws li tus me nyuam mos yuav tsum tau 24- teev kev saib xyuas, cov tshuaj npaj tau muab los ntawm micro-tswj infusion, nrog rau cov tshuaj ntxiv khaws cia rau hauv lub tub yees 4 degree. Txawm li cas los xij, txij li DEHP yog cov rog-soluble, nws tuaj yeem nkag mus rau hauv cov khoom noj khoom haus ntau tshaj 24 teev vim qhov kev ua ntawm lipid emulsion. DEHP tau raug pov thawj tias muaj kev cuam tshuam tsis zoo rau kev loj hlob ntawm cov menyuam mos thiab menyuam yaus.
Kev tshawb fawb qhia tau hais tias qhov kev puas tsuaj ntawm DEHP feem ntau yog nyob ntawm ob yam: tus neeg mob qhov rhiab heev rau DEHP, nrog cov txiv neej fetuses, cov me nyuam mos liab, thiab cov tub ntxhais hluas cov txiv neej tau txheeb xyuas tias muaj kev pheej hmoo siab; thiab tus nqi ntawm DEHP absorbed los ntawm tus neeg mob, uas nyob ntawm daim ntawv ntawm kev kho mob, nws zaus, thiab lub sij hawm ntawm kev kho mob tsis tu ncua.
Los ntawm kev txheeb xyuas qhov kev noj qab haus huv (TI) ntawm DEHP, nws tau pom tias cov kev kho mob hauv qab no ua rau muaj kev pheej hmoo siab rau DEHP raug: kev hloov pauv hauv cev xeeb tub, kev phais menyuam yaus extracorporeal membrane oxygenation (ECMO), kev noj zaub mov tsis zoo rau menyuam yaus (hauv PVC hnab uas muaj. lipids), ntau yam kev kho mob me nyuam mos (ntau raug), cov hluas txiv neej lim ntshav, lim ntshav rau cov poj niam cev xeeb tub thiab lactating cov poj niam cev xeeb tub thiab cov neeg laus noj zaub mov, hloov lub plawv, coronary artery bypass grafting (CABG), cov ntshav ntau rau cov neeg mob hnyav, thiab cov neeg laus ECMO phais.
Kev phom sij ntawm Phthalates
Toxicity rau txiv neej Reproductive System: Phthalates feem ntau nthuav tawm cov tshuaj toxicity rau cov qe ntshav, ua rau testicular atrophy, kev hloov pauv tseem ceeb hauv qib testosterone, txo qis hauv cov spermatogenic hlwb, txo qis hauv cov qog nqaij hlav enzyme, thiab txo cov phev suav.
01
Kev cuam tshuam rau Poj Niam Kev Ua Txhaum Cai: Phthalates ua rau muaj kuab lom rau ntawm lub tsev menyuam thiab zes qe menyuam, muaj peev xwm ua rau lub sijhawm ntev estrous, txo cov qib progesterone, nce uterine hnyav, hloov lub voj voog ntawm ovulation, thiab ua rau ncua sijhawm lossis anovulatory cycles.
02
Cov teebmeem ntawm Hematological System: Phthalates tuaj yeem txo cov qib hematocrit, txo cov ntsiab lus hemoglobin, thiab nce platelet adhesion.
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Teratogenicity: Cov kev tshawb fawb tau pom tias txawm tias cov tshuaj phthalates qis tuaj yeem ua rau muaj kev pheej hmoo ntawm kev yug menyuam. Kev kis mob hnyav tuaj yeem ua rau mob plawv, raum, thiab mob ntsws toxicity, uas ua rau tuag taus.
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Hepatotoxicity: Phthalates tuaj yeem ua rau oxidative puas tsuaj rau cellular proteins, daim siab cell membrane lipids, thiab DNA, uas yuav ua rau qia cell puas.
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Ntxiv nrog rau cov tshuaj lom ntawm DEHP, cov neeg mob kuj raug rau cov tshuaj lom ntawm DEHP's metabolite, mono(2-ethylhexyl) phthalate (MEHP). Qhov sib xyaw no tsim los ntawm hydrolysis ntawm DEHP hauv cov plasma khaws cia los yog cov ntshav vim yog kev ua ntawm lipases lossis thaum lub sijhawm khaws cia thiab cua sov ntawm cov tshuaj infusions. Qee cov DEHP tau tso rau hauv cov ntshav, ntshav, lossis cov kua dej ua ntej muab rau cov neeg mob thiab hloov mus rau MEHP, uas yog tshuaj lom ntau dua li DEHP, ua rau MEHP yog ib qho tseem ceeb ntawm cov tshuaj lom metabolite ntawm DEHP.