ЯДОВИТЫЕ ЖИВОТНЫЕ

IЯдови́тые живо́тные
животные, в организме которых постоянно или периодически содержатся вещества, токсичные для человека и особей других видов. Известно около 5 тыс. видов Я. ж. Различают активно- и пассивно-ядовитых животных. Активно-ядовитые животные имеют специализированные железы, вырабатывающие яд, служащий для защиты от врагов. У многих Я. ж. ядовитые железы связаны с ранящим аппаратом: такие Я. ж. используют яд и для нападения на жертву. У пассивно-ядовитых животных токсичные вещества содержатся в тех или иных тканях.
Токсины Я. ж. (зоотоксины) относятся к различным классам химических соединений. Многокомпонентность зоотоксинов обусловливает многообразие токсических эффектов в результате воздействия на различные системы организма. Так, белковый компонент животных ядов вызывает первичное поражение центральной и периферической нервной системы, нарушение ритма и проводимости сердца, которые часто сочетаются с тромбогеморрагическим синдромом: возможны также анафилактические реакции, т.к. многие белки являются сильными антигенами (см. Аллергия). Некоторые зоотоксины содержат гликозиды, которые воздействуют на автономные нервные окончания и вызывают одновременное поражение нервной, сердечно-сосудистой и пищеварительной систем. Индивидуальные реакции пострадавших на один и тот же зоотоксин различны. Особенно тяжело протекают токсикозы у детей. Кроме того, вероятность развития анафилактического шока (Анафилактический шок) значительно выше у лиц, ранее сенсибилизированных зоотоксинами.
Ядовитыми животными являются представители различных систематических групп, от простейших до позвоночных. Степень ядовитости представителей одного и того же вида может варьировать в зависимости от времени года, характера питания и других факторов. Большей токсичностью обладают самки.
Самцы некоторых видов Я. ж. вообще не ядовиты.
Среди простейших для человека ядовиты динофлагеллаты (панцирные жгутиконосцы). Яд (сакситоксин), относящийся к группе нейротоксинов, накапливается у них в специализированных органеллах типа стрекательных капсул (выделение токсина в воду вызывает так называемые красные приливы). При употреблении в пищу рыб и моллюсков, систематически питавшихся ядовитыми простейшими, могут развиваться острые отравления, характеризующиеся преимущественным поражением периферической нервной системы.
Из кишечнополостных ядовитыми для человека являются некоторые виды коралловых полипов и медуз. Ядовитый секрет выделяют стрекательные клетки щупалец. В состав яда входят различные органические кислоты, гистамин, серотонин или другие циклические амины и токсины белковой природы. В зависимости от компонентов эти яды могут оказывать местное раздражающее, прижигающее (токсический перматит), гемолитическое или нейротоксическое действие.
Из моллюсков к ядовитым относятся осьминоги, или спруты, и некоторые морские виды брюхоногих. У осьминогов ядовитый секрет выделяет задняя пара видоизмененных слюнных желез, у брюхоногих моллюсков ядовитые железы открываются в каналы зубцов радулы. Яд содержит гистамин, гиалуронидазу и другие компоненты, обладающие нейротоксическим действием. Осьминоги, как правило, не нападают на человека (нападение может быть обусловлено попыткой поймать осьминога или даже просто приблизиться к нему). Яд брюхоногих попадает в организм человека при уколе зубцами радулы. Возможно также отравление съедобными видами моллюсков (мидиями), питавшихся ядовитыми простейшими.
Ядовитыми членистоногими являются скорпионы, пауки, клещи и насекомые. Они имеют парные многоклеточные ядовитые железы, отверстия которых у скорпионов расположены на вершине острого жала на заднем конце тела, у пауков — на остриях хелицер (часть ротового аппарата), у насекомых — на различных придатках тела (например, на кончике жала у жалящих перепончатокрылых). Яд скорпионов относится к токсальбуминам и обладает кардиотропным действием. Яд пауков содержит различные аминокислоты, пептиды, гиалуронидазу и обладает местным раздражающим, прижигающим и нейротропным действием.
К ядовитым насекомым относятся пчелы, осы, шмели, шершни, многие виды муравьев, гусеницы дубового шелкопряда. Пчелы, осы, шмели, шершни вырабатывают сходный по составу яд, оказывающий как местное, так и общее токсическое действие. Ядовиты только самки. Яд муравьев и гусениц дубового шелкопряда вызывает токсический дерматит.
Среди иглокожих ядовиты некоторые виды голотурий (морских огурцов), морских ежей и звезд. Яд голотурий, содержащий кардиотропные и нейротропные гликозиды, продуцируется в так называемых кювьеровых органах, расположенных в кишечной полости. Отравление происходит при употреблении в пищу съедобных видов голотурий (трепангов) с неполностью удаленными внутренностями. Яд морских ежей и звезд вызывает главным образом местную реакцию — жжение, боль, зуд, отек в месте укола специализированными ядовитыми иглами.
Среди позвоночных ядовитыми для человека являются некоторые виды рыб, земноводных и пресмыкающихся. Активно-ядовитые рыбы имеют ядовитые железы, соединенные с шипами на плавниках (например, у скорпионовых, бородавчатки), на хвосте (например, у скатов-хвостоколов) или на жаберных крышках (у морских дракончиков). Яд этих рыб содержит нейропептиды и оказывает местное раздражающее и нейротоксическое действие. Отравление происходит при уколах ядовитыми шипами.
Пассивно-ядовитые рыбы вызывают главным образом пищевые отравления. Степень токсичности этих Я. ж. непостоянна и зависит от времени года, возраста рыб, состава планктона степени загрязненности воды и других факторов. Так, известно около 300 видов морских рыб, в т.ч. и промысловых, в организме которых при определенных условиях (предположительно при изменении обычного питания), главным образом в летний период, происходит накопление ихтиосаркотоксина (сигватотоксина, сигватерина), оказывающего нейротоксическое действие. Употребление этих рыб в пищу приводит к развитию тяжелого отравления, получившего название «сигватера». Некоторые рыбы (например щука, судак, налим, окунь, угорь) могут временно приобретать токсические свойства. Употребление этих рыб в пищу вызывает острое отравление, проявляющееся токсическим поражением скелетной мускулатуры и почек (см Юксовско-сартланская болезнь (Юксовско — Сартланская болезнь)).
У многих рыб зоотоксины содержатся в отдельных тканях и органах. Так, у некоторых видов угрей токсическими свойствами обладает кровь, у мурены — мышечная ткань. Сильнодействующий яд тетродотоксин, поражающий центральную и периферическую нервную систему, содержится во внутренних органах, икре, молоках и коже многих рыб отряда иглобрюхообразных, а также в икре, молоках и печени некоторых пресноводных рыб (например, усача, маринки) в период нереста. Ядовиты печень акул, особенно тропических, а также мясо полярной акулы. Отравление могут вызвать скумбриевые и ставридовые рыбы (при несоблюдении режима хранения гистидин, содержащийся в мышечной ткани этих рыб, превращается в активное гистаминоподобное вещество заурин, оказывающее нейротоксическое действие).
В классе земноводных ядовиты саламандры жабы, жерлянки. Ядовитые железы у этих животных расположены в различных участках кожи; при возникновении угрозы нападения ядовитый секрет этих желез тончайшими струйками выбрасывается на поверхность кожи. Яд саламандр (алкалоид саламандрин) оказывает резорбтивное нейротоксическое действие. Яд жаб содержит гликозиды буфотенин и буфотоксин, которые оказывают местное раздражающее действие на кожу и желудочно-кишечный тракт (при попадании ядовитого секрета внутрь), а также кардиотоксическое действие.
Среди пресмыкающихся ядовитыми являются змеи семейств аспидовых, гадюковых, ямкоголовых и морских, а также североамериканская ящерица ядозуб. Ядовитые железы этих животных развивались из слюнных и связаны с парными трубчатыми ядопроводящими зубами в верхнечелюстных костях. По составу и действию яда змей можно разделить на 2 группы. Яд аспидовых и морских змей, содержащий нейротоксины белковой природы и ферменты (гиалуронидазу, холинэстеразу, фосфолидазу, гистамин и др.), оказывает нейротоксическое и антикоагулирующее действие. В яде гадюковых и ямкоголовых преобладают ферменты (фосфолипаза, гиалуронидаза, лецитиназа); кроме того, яд гадюковых содержит виперотоксин, яд ямкоголовых — кротатоксин. Зоотоксины этих Я. ж. оказывают гемотоксическое и цитотоксическое действие, проявляющееся нарушениями свертываемости крови, повышением проницаемости сосудистой стенки с развитием отека и некроза пораженных участков.
Лечение острых отравлений животными ядами включает комплекс мероприятий по экстренной детоксикации организма, специфическую и симптоматическую терапию (табл.). Быстрое развитие токсического эффекта обусловливает необходимость экстренного оказания первой помощи (в т.ч. само- и взаимопомощи). Меры первой помощи зависят от пути попадания яда в организм человека.
При попадании токсичного вещества на кожу достаточно тщательно промыть пораженный участок проточной водой с мылом и нанести любой питательный крем на жировой основе.
Таблица
Характеристика и географический ареал ядовитых животных, наиболее часто вызывающих острые отравления у людей, основные клинические проявления отравлении и меры неотложной помощи
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| Ядовитое животное  | Географический     | Основные                    | Меры неотложной      |  |
|                                 | ареал                    | клинические                | помощи                     |  |
|                                 |                              | проявления                 |                                  |  |
|                                 |                              | отравления                  |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Простейшие                                                                                                                     |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Динофлагеллаты | Моря и                  | Через 20—30 мин        | Промывание желудка |  |
| или панцирные          | континентальные   | после употребления в  | через зонд. Внутрь    |  |
| жгутиконосцы           | водоемы в зоне     | пищу рыбы или            | солевое                     |  |
| (входят в состав       | тропиков                | моллюсков,                 | слабительное,            |  |
| планктона)                |                              | питавшихся                 | активированный         |  |
|                                 |                              | ядовитыми                  | уголь, обильное         |  |
|                                 |                              | простейшими,              | питье.                        |  |
|                                 |                              | развиваются               | Внутримышечно 1 мл |  |
|                                 |                              | парестезии в области  | 1% раствора              |  |
|                                 |                              | языка, губ, десен,       | димедрола,                |  |
|                                 |                              | лица. Возникают боли  | подкожно 1 мл 0,1%   |  |
|                                 |                              | в мышцах и суставах,  | раствора атропина.   |  |
|                                 |                              | миофибрилляции,        | При расстройстве      |  |
|                                 |                              | затруднение глотания. | дыхания показана      |  |
|                                 |                              | Позднее развиваются  | искусственная           |  |
|                                 |                              | парезы конечностей и  | вентиляция легких. В  |
|                                 |                              | дыхательных мышц.    | тяжелых случаях —   |  |
|                                 |                              | Возможны                   | гемосорбция              |  |
|                                 |                              | гастроинтестинальные |                                  |  |
|                                 |                              | и эритематозные         |                                  |  |
|                                 |                              | формы, протекающие  |                                  |  |
|                                 |                              | по типу аллергических |                                  |  |
|                                 |                              | реакций                       |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Кишечнополостные                                                                                                           |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Коралловые           | Все моря за           | Жжение, боль              | Промывание              |  |
полипы, актинии      | исключением         | местный отек,             | пораженного участка  |  |
|                                 | Аральского и         | гиперемия,                  | проточной водой с     |  |
|                                 | Каспийского          | крапивница                  | мылом. Местно          |  |
|                                 |                              |                                    | питательный крем на  |  |
|                                 |                              |                                    | жировой основе         |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Медузы Корнеротая  | Преимущественно | Жжение, боль,             | Промывание              |  |
|                                 | моря в зоне           | местный отек,             | пораженного участка  |  |
|                                 | тропиков, а также  | гиперемия,                  | проточной водой с     |  |
|                                 | Черное море,         | крапивница. Общий     | мылом. Местно          |  |
|                                 | опресненные         | токсикоз: боли в          | питательный крем на  |  |
|                                 | заливы Охотского  | груди, животе,             | жировой основе.        |  |
|                                 | моря                      | удушье, боли в            | Внутримышечно 1 мл |  |
|                                 |                              | суставах и мышцах,    | 5% раствора              |  |
|                                 |                              | подергивания мышц,   | эфедрина, 1 мл 1%    |  |
|                                 |                              | мышечная слабость    | раствора димедрола, |  |
|                                 |                              |                                    | 1 мл 2,5% раствора   |  |
|                                 |                              |                                    | тиамина хлорида;      |  |
|                                 |                              |                                    | подкожно 1 мл 0,1%   |  |
|                                 |                              |                                    | раствора атропина.    |  |
|                                 |                              |                                    | Показаны                   |  |
|                                 |                              |                                    | искусственная           |  |
|                                 |                              |                                    | вентиляция легких,    |  |
|                                 |                              |                                    | гемосорбция              |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Крестовичок             | Японское море,     |                                    |                                  |  |
|                                 | Амурский залив     |                                    |                                  |  |
|                                 | (прибрежная зона)  |                                   |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Кубомедуза              | Преимущественно | Жжение, боль,             | Промывание              |  |
|                                 | моря в зоне           | местный отек,             | пораженного участка  |  |
|                                 | тропиков (на          | гиперемия,                  | проточной водой с     |  |
|                                 | мелководье)          | крапивница                  | мылом. Местно          |  |
|                                 |                              |                                    | питательный крем на  |  |
|                                 |                              |                                    | жировой основе         |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Цианея                     | Атлантический,      |                                    |                                  |  |
| обыкновенная           | Тихий океаны,       |                                    |                                  |  |
|                                 | моря Северного     |                                    |                                  |  |
|                                 | Ледовитого            |                                    |                                  |  |
|                                 | океана                   |                                    |                                  |  |
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| Моллюски                                                                                                                        |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Осьминог, или       | Моря и океаны в    | В месте укуса острая  | Промывание              |  |
спрут                      | нашей стране —    | боль, жжение, зуд       | пораженного участка  |  |
|                                 | северные (за         | (характерно наличие    | проточной водой с     |  |
|                                 | исключением         | двух небольших          | мылом. Местно          |  |
|                                 | Белого) и               | ранок). Гиперемия,      | питательный крем на  |  |
|                                 | дальневосточные  | отек, судороги,            | жировой основе.        |  |
|                                 | моря                      | затруднение дыхания  | Иммобилизация         |  |
|                                 |                              |                                    | пораженной               |  |
|                                 |                              |                                    | конечности.               |  |
|                                 |                              |                                    | Подкожно 1 мл 1%     |  |
|                                 |                              |                                    | раствора димедрола  |  |
|                                 |                              |                                    | или 2% раствора        |  |
|                                 |                              |                                    | супрастина. Для        |  |
|                                 |                              |                                    | снятия боли               |  |
|                                 |                              |                                    | подкожно 1 мл 1%     |  |
|                                 |                              |                                    | раствора промедола.  |
|                                 |                              |                                    | При судорогах           |  |
|                                 |                              |                                    | внутримышечно 2 мл  |  |
|                                 |                              |                                    | 0,5% раствора           |  |
|                                 |                              |                                    | диазепама                 |  |
|                                 |                              |                                    | (седуксена) или         |  |
|                                 |                              |                                    | реланиума (в             |  |
|                                 |                              |                                    | тяжелых случаях       |  |
|                                 |                              |                                    | внутривенно в 20 мл  |  |
|                                 |                              |                                    | изотонического          |  |
|                                 |                              |                                    | раствора натрия        |  |
|                                 |                              |                                    | хлорида). При            |  |
|                                 |                              |                                    | нарушении дыхания   |  |
|                                 |                              |                                    | искусственная           |  |
|                                 |                              |                                    | вентиляция легких     |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Членистоногие                                                                                                                 |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Скорпионы             | Средняя Азия,       | В месте укуса боль,    | Выдавливание из       |  |
| Желтый или              | Казахстан,             | гиперемия, отек           | ранки первых капель  |  |
| пестрый                    | Южный Крым,        | (образуется несколько | крови и отсасывание  |  |
|                                 | Кавказ                   | пузырьков,                  | яда ртом (у                |  |
|                                 |                              | наполненных               | оказывающего           |  |
|                                 |                              | жидкостью). Тошнота, | помощь не должно     |  |
|                                 |                              | рвота, сонливость,      | быть свежих              |  |
|                                 |                              | озноб, головная боль,  | повреждений в           |  |
|                                 |                              | головокружение,          | полости рта).             |  |
|                                 |                              | ощущение                   | Введение                   |  |
|                                 |                              | сердцебиения. Через   | противоскорпионовой |  |
|                                 |                              | 15—30 мин после        | сыворотки (при ее      |  |
|                                 |                              | укуса клонико-             | отсутствии —            |  |
|                                 |                              | тонические судороги,  | противокаракуртовой  |
|                                 |                              | холодный пот,             | или сыворотки           |  |
|                                 |                              | нарастание одышки,    | антикобра) 500 ДЦЛ   |  |
|                                 |                              | тахикардия. На ЭКГ     | подкожно, в               |  |
|                                 |                              | — экстрасистолия,      | подлопаточную          |  |
|                                 |                              | иногда                         | область.                    |  |
|                                 |                              | пароксизмальная         | Циркулярная              |  |
|                                 |                              | мерцательная              | инфильтрационная     |  |
|                                 |                              | аритмия. Повышение   | блокада 0,5%             |  |
|                                 |                              | АД, затем понижение.  | раствором новокаина |  |
|                                 |                              | После улучшения        | на 10—15 см              |  |
|                                 |                              | состояния возможно    | проксимальнее          |  |
|                                 |                              | возобновление            | места укуса.              |  |
|                                 |                              | симптомов                  | Промывание ранки     |  |
|                                 |                              | отравления. В             | 1% раствором калия  |  |
|                                 |                              | тяжелых случаях         | перманганата.            |  |
|                                 |                              | может наступить         | Местно холод.           |  |
|                                 |                              | остановка дыхания.     | Иммобилизация         |  |
|                                 |                              |                                    | пораженной               |  |
|                                 |                              |                                    | конечности.               |  |
|                                 |                              |                                    | Обильное питье.        |  |
|                                 |                              |                                    | Внутривенно 10 мл    |  |
|                                 |                              |                                    | 10% раствора            |  |
|                                 |                              |                                    | кальция хлорида или  |  |
|                                 |                              |                                    | кальция глюконата,    |  |
|                                 |                              |                                    | 90—120 мг                 |  |
|                                 |                              |                                    | преднизолона,           |  |
|                                 |                              |                                    | подкожно 1 мл 1%     |  |
|                                 |                              |                                    | раствора димедрола, |  |
|                                 |                              |                                    | 1 мл 0,1% раствора   |  |
|                                 |                              |                                    | атропина. Для снятия |  |
|                                 |                              |                                    | боли внутримышечно  |
|                                 |                              |                                    | 2 мл 50% раствора    |  |
|                                 |                              |                                    | анальгина, подкожно  |  |
|                                 |                              |                                    | 1 мл 1% раствора      |  |
|                                 |                              |                                    | промедола                 |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Пауки                      | Северная Африка, | В месте укуса             | Выдавливание из       |  |
| Каракурт                  | Западная Азия,     | появляется                  | ранки первых капель  |  |
|                                 | Южная Европа; в   | маленькое, темное,     | крови и отсасывание  |  |
|                                 | нашей стране —    | быстро исчезающее    | яда ртом (у                |  |
|                                 | зона полупустынь, | пятно, через                | оказывающего           |  |
|                                 | пустынь,                | несколько минут —     | помощь не должно     |  |
|                                 | предгорий              | отек, сильные боли,     | быть свежих              |  |
|                                 |                              | распространяющиеся  | повреждений в           |  |
|                                 |                              | на конечности,            | полости рта).             |  |
|                                 |                              | поясницу, грудь,         | Введение                   |  |
|                                 |                              | живот, резкое              | противокаракуртовой  |
|                                 |                              | напряжение мышц       | сыворотки от 500 до   |
|                                 |                              | брюшного пресса.       | 1000 ДЦЛ подкожно   |  |
|                                 |                              | Озноб, повышение       | в подлопаточную       |  |
|                                 |                              | температуры тела,      | область (при тяжелой |  |
|                                 |                              | обильное                     | интоксикации             |  |
|                                 |                              | потоотделение,           | внутривенно              |  |
|                                 |                              | выраженное                | медленно 2500 ДЦЛ). |  |
|                                 |                              | психомоторное            | Циркулярная              |  |
|                                 |                              | возбуждение,              | инфильтрационная     |  |
|                                 |                              | галлюцинации, страх   | блокада 0,5%             |  |
|                                 |                              | смерти, тремор и         | раствором новокаина |  |
|                                 |                              | фибрилляции               | на 10—15 см              |  |
|                                 |                              | различных мышц,        | проксимальнее          |  |
|                                 |                              | затруднение дыхания, | места укуса.              |  |
|                                 |                              | тошнота, рвота.           | Промывание ранки     |  |
|                                 |                              | Возможны                   | 1% раствором калия  |  |
|                                 |                              | тахикардия,                 | перманганата.            |  |
|                                 |                              | экстрасистолия,          | Местно холод.           |  |
|                                 |                              | повышение АД,           | Иммобилизация         |  |
|                                 |                              | внезапная остановка   | пораженной               |  |
|                                 |                              | дыхания                      | конечности.               |  |
|                                 |                              |                                    | Обильное питье.        |  |
|                                 |                              |                                    | Внутривенно              |  |
|                                 |                              |                                    | капельно глюкозо-      |  |
|                                 |                              |                                    | новокаиновая смесь   |
|                                 |                              |                                    | (500 мл 5% раствора  |  |
|                                 |                              |                                    | глюкозы, 50 мл 2%     |  |
|                                 |                              |                                    | раствора новокаина),  |
|                                 |                              |                                    | 10 мл 10% раствора   |  |
|                                 |                              |                                    | кальция хлорида или  |  |
|                                 |                              |                                    | кальция глюконата.    |  |
|                                 |                              |                                    | При возбуждении       |  |
|                                 |                              |                                    | внутримышечно 2 мл  |  |
|                                 |                              |                                    | 0,5% раствора           |  |
|                                 |                              |                                    | диазепама. Для         |  |
|                                 |                              |                                    | снятия боли               |  |
|                                 |                              |                                    | внутримышечно 2 мл  |  |
|                                 |                              |                                    | 50% раствора            |  |
|                                 |                              |                                    | анальгина.                 |  |
|                                 |                              |                                    | Парентерально          |  |
|                                 |                              |                                    | гидрокортизон 250     |  |
|                                 |                              |                                    мг, преднизолон 60— |  |
|                                 |                              |                                    | 120 мг. Подкожно 1— |  |
|                                 |                              |                                    | 2 мл 1% раствора      |  |
|                                 |                              |                                    | димедрола (или 2,5% |  |
|                                 |                              |                                    | раствора                    |  |
|                                 |                              |                                    | пипольфена), 2 мл     |  |
|                                 |                              |                                    | кордиамина, 1 мл       |  |
|                                 |                              |                                    | 20% раствора            |  |
|                                 |                              |                                    | кофеина. Внутрь        |  |
|                                 |                              |                                    | витаминные               |  |
|                                 |                              |                                    | препараты (по 0,1 г    |  |
|                                 |                              |                                    | аскорбиновой             |  |
|                                 |                              |                                    | кислоты, 0,05 г           |  |
|                                 |                              |                                    | никотиновой кислоты  |  |
|                                 |                              |                                    | 3 раза в день).           |  |
|                                 |                              |                                    | Форсированный         |  |
|                                 |                              |                                    | диурез. При               |  |
|                                 |                              |                                    | расстройстве             |  |
|                                 |                              |                                    | дыхания                    |  |
|                                 |                              |                                    | искусственная           |  |
|                                 |                              |                                    | вентиляция легких     |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Тарантул                  | Зона                      | В месте укуса острая  | Выдавливание из       |  |
|                                 | полупустынь,         | боль, парестезии,        | ранки первых капель  |  |
|                                 | пустынь; степи      | гиперемия,                  | крови и отсасывания  |  |
|                                 | юга европейской    | распространенный       | яда ртом (у                |  |
|                                 | части страны.        | отек, характерно         | оказывающего           |  |
|                                 | Кавказ,                  | наличие следа укуса.  | помощь не должно     |  |
|                                 | Казахстан,             | Тяжесть во всем         | быть свежих              |  |
|                                 | Средняя Азия        | теле, сонливость.        | повреждений в           |  |
|                                 | (долины рек,          | Повышение АД,           | полости рта).             |  |
|                                 | местами лесная     | тахикардия, затем       | Введение                   |  |
|                                 | зона)                     | понижение АД.            | противокаракуртовой  |
|                                 |                              | Возможен коллапс       | сыворотки от 500 до   |
|                                 |                              |                                    | 2000 ДЦЛ подкожно   |  |
|                                 |                              |                                    | в подлопаточную       |  |
|                                 |                              |                                    | область (при тяжелой |  |
|                                 |                              |                                    | интоксикации             |  |
|                                 |                              |                                    | внутривенно              |  |
|                                 |                              |                                    | медленно).                 |  |
|                                 |                              |                                    | Циркулярная              |  |
|                                 |                              |                                    | инфильтрационная     |  |
|                                 |                              |                                    | блокада 0,5%             |  |
|                                 |                              |                                    | раствором новокаина |  |
|                                 |                              |                                    | на 10—15 см              |  |
|                                 |                              |                                    | проксимальнее          |  |
|                                 |                              |                                    | места укуса,              |  |
|                                 |                              |                                    | промывание ранки     |  |
|                                 |                              |                                    | 1% раствором калия  |  |
|                                 |                              |                                    | перманганата.            |  |
|                                 |                              |                                    | Местно холод.           |  |
|                                 |                              |                                    | Иммобилизация         |  |
|                                 |                              |                                    | пораженной части      |  |
|                                 |                              |                                    | тела. Внутривенно     |  |
|                                 |                              |                                    | 10 мл 10% раствора   |  |
|                                 |                              |                                    | кальция хлорида или  |  |
|                                 |                              |                                    | кальция глюконата.    |  |
|                                 |                              |                                    | При выраженном        |  |
|                                 |                              |                                    | снижении АД             |  |
|                                 |                              |                                    | внутривенно              |  |
|                                 |                              |                                    | капельно 1—2 мл       |  |
|                                 |                              |                                    | 0,2% раствор             |  |
|                                 |                              |                                    | норадреналина в        |  |
|                                 |                              |                                    | 100 мл 5% раствора   |  |
|                                 |                              |                                    | глюкозы. Подкожно    |  |
|                                 |                              |                                    | 1 мл 1% раствора      |  |
|                                 |                              |                                    | димедрола. Для         |  |
|                                 |                              |                                    | снятия боли               |  |
|                                 |                              |                                    | внутримышечно 2 мл  |  |
|                                 |                              |                                    | 50% раствора            |  |
|                                 |                              |                                    | анальгина                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Насекомые  Пчелы,  | Распространены    | В месте укуса жгучая  | Удаление жала с        |  |
| шмели                      | широко                  | боль, бледная папула  | пузырьком,                |  |
|                                 |                              | с кольцом гиперемии   | наполненным ядом.   |  |
|                                 |                              | и отеком окружающих | Промывание ранки     |  |
|                                 |                              | тканей различной        | спиртом. Местно        |  |
|                                 |                              | протяженности. При    | холод (лед). При        |  |
|                                 |                              | укусах в лицо или        | тяжелой                     |  |
|                                 |                              | шею отек наиболее      | интоксикации             |  |
|                                 |                              | выражен и нередко      | циркулярная              |  |
|                                 |                              | сопровождается          | послойная                  |  |
|                                 |                              | лимфаденитом. При    | инфильтрационная     |  |
|                                 |                              | укусе в глаз                | блокада мест укусов  |  |
|                                 |                              | слезотечение,             | 0,5% раствором         |  |
|                                 |                              | конъюнктикит,             | новокаина.                 |  |
|                                 |                              | блефарит. Озноб,        | Внутривенно 10 мл    |  |
|-----------------------------------------------------------------| повышение                  | 10% раствора            |--|
| Осы, шершни            | Распространены    | температура тела,       | кальция хлорида или  |  |
|                                 | широко                  | одышка,                      | кальция глюконата.    |  |
|                                 |                              | головокружение,          | Подкожно 1 мл 1%     |  |
|                                 |                              | тахикардия, тошнота,  | раствора димедрола  |  |
|                                 |                              | снижение АД,              | или 1 мл 2,5%            |  |
|                                 |                              | судороги, угнетение    | раствора                    |  |
|                                 |                              | дыхания. Возможно     | пипольфена.              |  |
|                                 |                              | развитие гемолиза,      | Внутримышечно         |  |
|                                 |                              | гемоглобинурии.          | глюкокортикоиды       |  |
|                                 |                              | Степень тяжести         | (гидрокортизон до      |  |
|                                 |                              | токсикоза висит от      | 250 мг, преднизолон   |
|                                 |                              | индивидуальной          | до 120 мг). Обильное  |
|                                 |                              | чувствительности        | питье (жидкость с      |  |
|                                 |                              | организма,                  | гидрокарбонатом       |  |
|                                 |                              | локалицазии и             | натрия). Внутрь         |  |
|                                 |                              | количества укусов       | витаминные               |  |
|                                 |                              |                                    | препараты (по 0,1 г    |  |
|                                 |                              |                                    | аскорбиновой             |  |
|                                 |                              |                                    | кислоты, 0,05 г           |  |
|                                 |                              |                                    | рутина, 0,05 г             |  |
|                                 |                              |                                    | никотиновой кислоты  |  |
|                                 |                              |                                    | 3 раза в день). При    |  |
|                                 |                              |                                    | развитии судорог       |  |
|                                 |                              |                                    | подкожно или             |  |
|                                 |                              |                                    | внутримышечно 2 мл  |  |
|                                 |                              |                                    | 0,5% раствора           |  |
|                                 |                              |                                    | седуксена                  |  |
|                                 |                              |                                    | (диазепама). В           |  |
|                                 |                              |                                    | наиболее тяжелых     |  |
|                                 |                              |                                    | случаях внутривенно  |
|                                 |                              |                                    | капельно вводят 400  |  |
|                                 |                              |                                    мл реополиглюкина    |  |
|                                 |                              |                                    | (полиглюкина) с 30—  |  |
|                                 |                              |                                    | 60 мг преднизолона,   |
|                                 |                              |                                    | 1 мл мезатона.           |  |
|                                 |                              |                                    | Показана                   |  |
|                                 |                              |                                    | искусственная           |  |
|                                 |                              |                                    | вентиляция легких,    |  |
|                                 |                              |                                    | при гемолизе —         |  |
|                                 |                              |                                    | форсированный         |  |
|                                 |                              |                                    | диурез                       |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Муравьи                   | Распространены    | Жжение, боль,             | Промывание              |  |
|                                 | широко, кроме       | местный отек,             | пораженного участка  |  |
|                                 | Антарктиды и        | гиперемия,                  | проточной водой с     |  |
|                                 | Крайнего Севера   | крапивница                  | мылом. Местно          |  |
|                                 |                              |                                    | питательный крем на  |  |
|                                 |                              |                                    | жировой основе         |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Дубовый шелкопряд  | Китай, Япония,      |                                    |                                  |  |
| (гусеница)                 | Приамурье,           |                                    |                                  |  |
|                                 | Южное Приморье  |                                    |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Иглокожие                                                                                                                        |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Голотурии, или       | Повсеместно; в     | Жжение, боль, отек,    | Промывание              |  |
| морские огурцы        | нашей стране —    | гиперемия,                  | пораженного участка  |  |
| (съедобные виды —  | дальневосточные  | крапивница                  | проточной водой с     |  |
| трепанги)                  | моря                      |                                    | мылом. Местно          |  |
|                                 |                              |                                    | питательный крем на  |  |
|                                 |                              |                                    | жировой основе.        |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Морские ежи          | Моря и океаны в    | При пероральном        | При пероральном       |  |
|                                 | зоне тропиков        | отравлении тошнота,   | отравлении                |  |
|                                 |                              | рвота, жжение во рту,  | промывание желудка |  |
|                                 |                              | глотке, пищеводе.       | через зонд. Внутрь    |  |
|                                 |                              | Боли в животе, понос, | солевое                     |  |
|                                 |                              | обезвоживание            | слабительное,            |  |
|-----------------------------------------------------------------| организма, иногда       | активированный         |--|
Морские звезды    | Моря и океаны       | испражнения с            | уголь, обильное         |  |
|                                 |                              | примесью крови          | питье. Внутривенно   |  |
|                                 |                              |                                    | капельно 100—150     |  |
|                                 |                              |                                    мл 4% раствора         |  |
|                                 |                              |                                    | натрия                       |  |
|                                 |                              |                                    | гидрокарбоната. При  |  |
|                                 |                              |                                    | обезвоживании          |  |
|                                 |                              |                                    | внутривенная             |  |
|                                 |                              |                                    | коррекция водно-       |  |
|                                 |                              |                                    | электролитного          |  |
|                                 |                              |                                    | баланса. Для снятия  |  |
|                                 |                              |                                    | болей подкожно 1—   |  |
|                                 |                              |                                    | 2 мл 0,1% раствора   |  |
|                                 |                              |                                    | атропина                    |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Позвоночные                                                                                                                    |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Рыбы активно-       | Атлантический       | В месте укола             | В область поражения |  |
ядовитые                | океан, Баренцево,  | отмечается резкая      | вводят 1 мл 0,5—2%  |  |
| Скорпеновые            | Черное и               | боль. Кожа вокруг       | раствора новокаина   |  |
| (морской окунь,        | дальневосточные  | ранки бледнеет, затем | с 1 мл 0,1% раствора |  |
| скорпена, или           | моря                      | появляются                 | адреналина,               |  |
| морской ерш)            |                              | гиперемия, цианоз,      | внутримышечно 2 мл  |  |
|                                 |                              | отек (иногда                | 50% раствора            |  |
|                                 |                              | значительной              | анальгина и 1 мл 1%  |  |
|                                 |                              | протяженности). В       | раствора промедола.  |
|                                 |                              | течение нескольких     | Внутривенно 10 мл    |  |
|-----------------------------------------------------------------| часов нарастают         | 10% раствора            |--|
| Скаты-хвостоколы    | Моря и океаны в    | симптомы токсикоза:   | кальция глюконата.    |  |
| (морской кот,            | зоне тропиков и     | возникают тошнота,     | При сердечно-           |  |
| красный хвостокол)  | субтропиков,          | рвота, понос,               | сосудистой                |  |
|                                 | Черное и               | головокружение,          | недостаточности        |  |
|                                 | Азовское моря,      | озноб, повышение       | внутривенно              |  |
|                                 | Южное Приморье  | температуры тела.       | капельно 5 мл 0,5%   |  |
|                                 | (прибрежная зона)  | Иногда бред,              | раствора дофамина   |  |
|                                 |                              | судороги, потеря         | или 1 мл 0,25%          |  |
|                                 |                              | сознания. Тахикардия  | раствора                   |  |
|                                 |                              | и брадикардия;,           | норадреналина в 5%  |  |
|                                 |                              | снижение АД,              | растворе глюкозы      |  |
|                                 |                              | нарушения дыхания    | или 0,9% растворе     |  |
|                                 |                              |                                    | натрия хлорида. При  |  |
|                                 |                              |                                    | судорогах                  |  |
|                                 |                              |                                    | внутривенно              |  |
|                                 |                              |                                    | капельно 2 мл 0,5%   |  |
|                                 |                              |                                    | раствора диазепама.  |  |
|                                 |                              |                                    | Для профилактики     |  |
|                                 |                              |                                    | вторичной инфекции  |  |
|                                 |                              |                                    | ран показаны             |  |
|                                 |                              |                                    | антибиотики               |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Бородавчатка           | Красное море.       |                                    |                                  |  |
|                                 | Индийский океан и |                                    |                                  |  |
|                                 | западная часть      |                                    |                                  |  |
|                                 | Тихого океана        |                                    |                                  |  |
|                                 | (прибрежная зона)  |                                   |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Морские дракончики | У берегов Европы, |                                    |                                  |  |
|                                 | Западной Африки  |                                    |                                  |  |
|                                 | Черное море,         |                                    |                                  |  |
|                                 | редко Балтийское  |                                    |                                  |  |
|                                 | (на мелководье)     |                                    |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Рыбы пассивно-    | Все океаны в зоне | Тошнота, рвота, боли   | Промывание желудка |  |
ядовитые                | тропиков.               | в животе. Нарушение  | через зонд, внутрь     |  |
| Акулы (тропическая, | Северный              | координации                | солевое                     |  |
| полярная)                 | Ледовитый океан   | движений, спазмы       | слабительное,            |  |
|                                 |                              | скелетных мышц,        | активированный         |  |
|                                 |                              | судороги                     | уголь, обильное         |  |
|                                 |                              |                                    | питье.                        |  |
|                                 |                              |                                    | Внутримышечно 2 мл |  |
|                                 |                              |                                    | 0,5% раствора           |  |
|                                 |                              |                                    | диазепама;                |  |
|                                 |                              |                                    | внутривенно 200—     |  |
|                                 |                              |                                    | 400 мл гемодеза,       |  |
|                                 |                              |                                    | 400 мл 5% раствора   |  |
|                                 |                              |                                    | глюкозы, 400 мл         |  |
|                                 |                              |                                    | изотонического          |  |
|                                 |                              |                                    | раствора натрия        |  |
|                                 |                              |                                    | хлорида                     |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Скумбриевые            | Тропические,         | Гиперемия,                  | Промывание              |  |
| (тунец, пеламида,     | субтропические,    | крапивница, тошнота,  | желудка, внутрь        |  |
| скумбрия, макрель)  | умеренные воды    | рвота, слюнотечение.  | солевое                     |  |
|                                 | Мирового океана   | Тахикардия, снижение | слабительное,            |  |
|                                 |                              | АД, бронхоспазм         | активированный         |  |
|                                 |                              |                                    | уголь, обильное         |  |
|                                 |                              |                                    | питье. Подкожно 2     |  |
|                                 |                              |                                    мл 2,5% раствора      |  |
|                                 |                              |                                    | пипольфена или 1 мл |  |
|                                 |                              |                                    | 1% раствора              |  |
|                                 |                              |                                    | димедрола.                |  |
|                                 |                              |                                    | Внутривенно 10 мл    |  |
|                                 |                              |                                    | 10% раствора            |  |
|                                 |                              |                                    | кальция глюконата     |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Ставридовые            | Тропические,         |                                    |                                  |  |
| (обыкновенная,         | субтропические,    |                                    |                                  |  |
| средиземноморская, | умеренные воды    |                                    |                                  |  |
| японская)                 | Мирового океана   |                                    |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Иглобрюхообразные  | Тропические воды | Через 10—15 мин        | Промывание              |  |
|                                 | Мирового океана   | после употребления    | желудка, внутрь        |  |
|                                 |                              | рыбы в пищу               | солевое                     |  |
|                                 |                              | появляются жжение в  | слабительное,            |  |
|                                 |                              | области губ, языка,     | активированный         |  |
|-----------------------------------------------------------------| першение в горле,       | уголь, обильное         |--|
| Собака-рыба, или      | Японское море      | затем онемение,          | питье.                        |  |
| рыба фугу                |                              | слюнотечение, рвота.  | Внутримышечно 1 мл |  |
|                                 |                              | Отмечаются понос,     | 2,5% раствора           |  |
|                                 |                              | боли в животе;            | тиамина бромида, 1   |  |
|                                 |                              | миофибрилляции,        мл 0,05% раствора    |  |
|-----------------------------------------------------------------| потеря                        | прозерина. При          |--|
| Еж-рыба                   | Тропические воды | чувствительности        | судорогах                  |  |
|                                 | Мирового океана   | кожи; затруднение       | внутривенно 2 мл       |  |
|                                 |                              | глотания, афония,       | 0,05% раствора         |  |
|                                 |                              | паралич дыхательных  | диазепама. Показаны |  |
|                                 |                              | мышц                          | искусственная           |  |
|                                 |                              |                                    | вентиляция легких,    |  |
|                                 |                              |                                    | форсированный         |  |
|                                 |                              |                                    | диурез, в тяжелых     |  |
|                                 |                              |                                    | случаях —                 |  |
|                                 |                              |                                    | гемосорбция              |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
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|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Кузовковые              | Тропические моря  |                                   |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Рыбы,                     | Тропические и       | Тошнота, рвота, боли  | Промывание              |  |
вызывающие          | субтропические     | в животе, понос           | желудка, внутрь        |  |
сигватеру (более    | воды Мирового      | (могут появиться         | солевое                     |  |
| 300 видов, в т.ч.       | океана,                  | через 30 ч после         | слабительное,            |  |
| промысловые           | зараженные           | употребления рыбы в  | активированный         |  |
| например                  | токсичным             | пищу). Затем               | уголь, обильное         |  |
| барракудовые или    | планктоном            | головная боль,            | питье.                        |  |
| морские щуки,          |                              | судороги, мышечная   | Внутримышечно 1 мл |  |
| рыбы-попугаи,          |                              | слабость,                    | 1% раствора              |  |
| рыбы-хирурги)          |                              | миофибрилляции.        | димедрола,                |  |
|                                 |                              | Расстройство              | подкожно 1 мл 0,1%   |  |
|                                 |                              | дыхания вследствие   | раствора атропина.    |  |
|                                 |                              | нарастающей              | При судорогах           |  |
|                                 |                              | слабости                     | внутримышечно 2 мл  |  |
|                                 |                              | дыхательных мышц     | 0,5% раствора           |  |
|                                 |                              |                                    | диазепама. При         |  |
|                                 |                              |                                    | расстройстве             |  |
|                                 |                              |                                    | дыхания показана      |  |
|                                 |                              |                                    | искусственная           |  |
|                                 |                              |                                    | вентиляция легких.    |  |
|                                 |                              |                                    | Форсированный         |  |
|                                 |                              |                                    | диурез. В тяжелых     |  |
|                                 |                              |                                    | случаях —                 |  |
|                                 |                              |                                    | гемосорбция              |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Рыбы,                     | Пресноводные       | Резкие боли в              | Постельный режим,   |  |
вызывающие          | водоемы                | мышцах конечностей,  | обильное питье,         |  |
юксовско-               | (преимущественно | поясничного отдела,    | тепло. Витаминные    |  |
сартлянскую          | озера)                    | грудной клетки;           | препараты:                |  |
болезнь (щука,        |                              | мышечная слабость    | внутримышечно по     |  |
| судак, налим, окунь, |                              | (через 8—10 ч после   | 2—3 мл 6% раствора  |
| угорь и др.)              |                              | употребления рыбы в  | тиамина хлорида,       |  |
|                                 |                              | пищу). Боли                | 2—3 мл 5% раствора  |
|                                 |                              | усиливаются при         | пиридоксина, 1 мл     |  |
|                                 |                              | малейшем движении,  | 1% раствора              |  |
|                                 |                              | в тяжелых случаях      | никотиновой               |  |
|                                 |                              | распространяются на  | кислоты;                    |  |
|                                 |                              | все скелетные             | внутривенно 2—3 мл  |  |
|                                 |                              | мышцы, кроме мышц   | 5% раствора              |  |
|                                 |                              | лица и волосистой       | аскорбиновой             |  |
|                                 |                              | части головы. Цианоз, | кислоты с 20 мл         |  |
|                                 |                              | сухость во рту,           | изотонического          |  |
|                                 |                              | иногда рвота. Моча     | раствора натрия        |  |
|                                 |                              | красно-коричневого     | хлорида. Для снятия  |  |
|                                 |                              | цвета (в тяжелых         | болей                         |  |
|                                 |                              | случаях почти             | внутримышечно 2 мл  |  |
|                                 |                              | черная). Болевой         | 50% раствора            |  |
|                                 |                              | приступ длится от 3 ч  | анальгина или 5 мл    |  |
|                                 |                              | до 4 сут., затем боли   | баралгина. При          |  |
|                                 |                              | стихают, моча             | сильных болях           |  |
|                                 |                              | приобретает                | подкожно 1 мл 2%     |  |
|                                 |                              | нормальную окраску.  | раствора промедола   |
|                                 |                              | В тяжелых случаях     | или омнопона. В        |  |
|                                 |                              | развивается острая     | тяжелых случаях       |  |
|                                 |                              | анурия (на 2—3-й        | показаны                   |  |
|                                 |                              | день после                  | форсированный         |  |
|                                 |                              | отравления)                 | диурез, гемодиализ   |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Земноводные                                                                                                                   |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Саламандры          | Центральная и       | Двигательное              | При судорогах           |  |
|                                 | Южная Европа,     | возбуждение,              | внутривенно              |  |
|                                 | Северо-Западная   | судороги. Затем          | капельно 2 мл 0,5%   |  |
|                                 | Африка, Юго-        | заторможенность,       | раствора диазепама.  |  |
|                                 | Западная Азия,     | потеря сознания,         | При расстройстве      |  |
|                                 | Западная               | угнетение дыхания      | дыхания                    |  |
|                                 | Украина,                |                                    | искусственная           |  |
|                                 | Западный Кавказ   |                                    | вентиляция легких     |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Жабы                       | Степная и лесная  | Эритема, явления        | Промывание              |  |
| Обыкновенная, или   | зоны страны          | токсического               | пораженного участка  |  |
| серая                       |                              | дерматита.                  | проточной водой с     |  |
|                                 |                              | При пероральном        | мылом, повязка с       |  |
|                                 |                              | отравлении тошнота,   | гидрокортизоновой     |  |
|                                 |                              | рвота, жжение во рту,  | мазью и                    |  |
|                                 |                              | пищеводе. Боли в       | анестезином.             |  |
|                                 |                              | животе, понос, иногда | При пероральном       |  |
|                                 |                              | испражнения с            | отравлении                |  |
|                                 |                              | примесью крови,         | промывание желудка  |
|                                 |                              | обезвоживание            | через зонд, внутрь     |  |
|-----------------------------------------------------------------| организма.                  | солевое                     |--|
| Зеленая                    | Степная и лесная  | Брадикардия,              | слабительное,            |  |
|                                 | зоны страны, горы | экстрасистолия,          | активированный         |  |
|                                 | (на высоте до        | нарушение                  | уголь, обильное         |  |
|                                 | 4500 м)                  | проводимости,            | питье,                        |  |
|                                 |                              | мерцание предсердий  | обволакивающие       |  |
|                                 |                              | и фибрилляция            | средства.                  |  |
|                                 |                              | желудочков. Падение  | Внутривенно              |  |
|                                 |                              | АД. Цианоз, судороги, | капельно 500 мл        |  |
|                                 |                              | потеря сознания          | 0,5% раствора калия  |  |
|                                 |                              |                                    | хлорида, 20 мл 10%   |  |
|                                 |                              |                                    | раствора кальция       |  |
|                                 |                              |                                    | тетацина в 300 мл      |  |
|                                 |                              |                                    | 5% раствора              |  |
|                                 |                              |                                    | глюкозы.                    |  |
|                                 |                              |                                    | Внутримышечно 5 мл |  |
|                                 |                              |                                    | 5% раствора              |  |
|                                 |                              |                                    | унитиола, по 1—2 мл  |  |
|                                 |                              |                                    | 30% раствора α-        |  |
|                                 |                              |                                    | токоферола ацетата   |  |
|                                 |                              |                                    | 4 раза в сутки. При    |  |
|                                 |                              |                                    | брадикардии 1 мл      |  |
|                                 |                              |                                    | 0,1% раствора           |  |
|                                 |                              |                                    | атропина. При            |  |
|                                 |                              |                                    | мерцании                   |  |
|                                 |                              |                                    | предсердий и             |  |
|                                 |                              |                                    | фибрилляции             |  |
|                                 |                              |                                    | желудочков               |  |
|                                 |                              |                                    | внутривенно 5 мл       |  |
|                                 |                              |                                    | 10% раствора            |  |
|                                 |                              |                                    | новокаинамида,         |  |
|                                 |                              |                                    | показана                    |  |
|                                 |                              |                                    | детоксикационная      |  |
|                                 |                              |                                    | гемосорбция              |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Пресмыкающиеся                                                                                                         |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
| Аспидовые змеи       | Африка, Южная     | В области укуса боль, | Выдавливание из       |  |
| Индийская кобра,     | Азия, Южная и      | незначительный отек:  | ранки первых капель  |  |
| или очковая змея      | Центральная         | паралич двигательной | крови и отсасывание  |  |
|                                 | Америка                | мускулатуры,              | яда ртом (у                |  |
|                                 |                              | распространяющийся  | оказывающего           |  |
|                                 |                              | затем на мышцы          | помощь не должно     |  |
|                                 |                              | туловища и лица.        | быть свежих              |  |
|                                 |                              | Затруднение               | повреждений в           |  |
|                                 |                              | глотания. Нарушение   | полости рта).             |  |
|                                 |                              | дыхания                      | Введение                   |  |
|                                 |                              |                                    | специфической          |  |
|                                 |                              |                                    | сыворотки                  |  |
|                                 |                              |                                    | (антикобра) от 500 до |  |
|                                 |                              |                                    | 2000 АЕ или 500 АЕ   |  |
|                                 |                              |                                    | поливалентной           |  |
|-----------------------------------------------------------------|                                    | противозмеиной         |--|
| Среднеазиатская      | Средняя Азия (юг  |                                    | сыворотки подкожно,  |
| кобра                        | Туркмении,            |                                    | в подлопаточную       |  |
|                                 | Таджикистана,       |                                    | область. Введение     |  |
|                                 | Узбекистана)         |                                    | противостолбнячной   |
|                                 |                              |                                    | сыворотки (по            |  |
|                                 |                              |                                    | Безредке).                 |  |
|                                 |                              |                                    | Циркулярная              |  |
|                                 |                              |                                    | инфильтрационная     |  |
|                                 |                              |                                    | блокада 0,5%             |  |
|                                 |                              |                                    | раствором новокаина |  |
|                                 |                              |                                    | на 10—15 см              |  |
|                                 |                              |                                    | проксимальнее          |  |
|                                 |                              |                                    | места укуса.              |  |
|                                 |                              |                                    | Промывание ранки     |  |
|                                 |                              |                                    | 1% раствором калия  |  |
|-----------------------------------------------------------------|                                    | перманганата.            |--|
| Мамба                      | Африка (к югу от   |                                    | Местно холод.           |  |
|                                 | Сахары)                 |                                    | Иммобилизация         |  |
|                                 |                              |                                    | пораженной части      |  |
|                                 |                              |                                    | тела. Обильное          |  |
|                                 |                              |                                    | питье.                        |  |
|                                 |                              |                                    | Внутримышечно         |  |
|                                 |                              |                                    | кортикостероиды.      |  |
|                                 |                              |                                    | При нарушении          |  |
|                                 |                              |                                    | дыхания показана      |  |
|                                 |                              |                                    | искусственная           |  |
|                                 |                              |                                    | вентиляция легких,    |  |
|                                 |                              |                                    | форсированный         |  |
|                                 |                              |                                    | диурез, гемосорб       |  |
|                                 |                              |                                    | ция                            |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
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|                                 |                              |                                    |                                  |  |
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|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Морские змеи        | Тропические воды | В месте укуса             | Выдавливание из       |  |
|                                 | Индийского и         | незначительная боль   | ранки первых капель  |  |
|                                 | Тихого океанов      | (обычно в течение 1 ч  | крови и отсасывание  |  |
|                                 |                              | с момента укуса).        | яда ртом (у                |  |
|                                 |                              | Затем эйфория,          | оказывающего           |  |
|                                 |                              | беспокойство, при       | помощь не должно     |  |
|                                 |                              | движениях ноющая     | быть свежих              |  |
|                                 |                              | боль в мышцах.           | повреждений в           |  |
|                                 |                              | Ощущение                  | полости рта).             |  |
|                                 |                              | «разбухания» языка,   | Введение                   |  |
|                                 |                              | мышечная слабость.   | специфической          |  |
|                                 |                              | Возможны вялые         | сыворотки                  |  |
|                                 |                              | спинальные и              | (антикобра) от 500 до |  |
|                                 |                              | бульбарные парезы     | 2000 АЕ или 500 АЕ   |  |
|                                 |                              | (через несколько         | поливалентной           |  |
|                                 |                              | часов). В тяжелых       | противозмеиной         |  |
|                                 |                              | случаях общий            | сыворотки подкожно,  |
|                                 |                              | паралич, начиная с      | в подлопаточную       |  |
|                                 |                              | мышц ног, туловища,   | область. Введение     |  |
|                                 |                              | затем рук, шеи.           | противостолбнячной   |
|                                 |                              | Характерны спазм       | сыворотки (по            |  |
|                                 |                              | мышц нижней              | Безредке). В              |  |
|                                 |                              | челюсти, опущение     | тяжелых случаях       |  |
|                                 |                              | век. Нередки тошнота, | введение сыворотки   |
|                                 |                              | рвота, возможна          | внутривенно              |  |
|                                 |                              | миоглобинурия. При    | капельно                    |  |
|                                 |                              | прогрессировании       | одновременно с         |  |
|                                 |                              | процесса ослабление  | гормональными и       |  |
|                                 |                              | пульса, падение АД.   | антигистаминными     |  |
|                                 |                              | Затруднение речи и     | препаратами:             |  |
|                                 |                              | глотания,                     | внутримышечно         |  |
|                                 |                              | расстройство              | 125—250 мг               |  |
|                                 |                              | сознания,                    | гидрокортизона,         |  |
|                                 |                              | генерализованные       | подкожно 1 мл 1%     |  |
|                                 |                              | судороги                     | раствора димедрола. |  |
|                                 |                              |                                    | Циркулярная              |  |
|                                 |                              |                                    | инфильтрационная     |  |
|                                 |                              |                                    | блокада 0,5%             |  |
|                                 |                              |                                    | раствором новокаина |  |
|                                 |                              |                                    | на 10—15 см              |  |
|                                 |                              |                                    | проксимальнее          |  |
|                                 |                              |                                    | места укуса.              |  |
|                                 |                              |                                    | Промывание ранки     |  |
|                                 |                              |                                    | 1% раствором калия  |  |
|                                 |                              |                                    | перманганата.            |  |
|                                 |                              |                                    | Местно холод.           |  |
|                                 |                              |                                    | Иммобилизация         |  |
|                                 |                              |                                    | пораженной               |  |
|                                 |                              |                                    | конечности.               |  |
|                                 |                              |                                    | Обильное питье. В     |  |
|                                 |                              |                                    | тяжелых случаях       |  |
|                                 |                              |                                    | форсированный         |  |
|                                 |                              |                                    | диурез. При               |  |
|                                 |                              |                                    | выраженной               |  |
|                                 |                              |                                    | миоглобинурии с        |  |
|                                 |                              |                                    | нарушением функции |  |
|                                 |                              |                                    | почек показан            |  |
|                                 |                              |                                    | гемодиализ                |  |
|--------------------------------------------------------------------------------------------------------------------------------------------|
Гадюковые змеи   | Африка, Европа,   | В месте укуса             | Выдавливание из       |  |
| Гюрза                       | Азия                      | сильная,                      | ранки первых капель  |  |
|                                 |                              | продолжительная        | крови и отсасывание  |  |
|                                 |                              | боль. Нарастающий (в | ртом яда из ранки (у  |  |
|                                 |                              | течение 1—2 сут.)       | оказывающего           |  |
|                                 |                              | отек, цианоз.               | помощь не должно     |  |
|                                 |                              | Подкожные                  | быть свежих              |  |
|-----------------------------------------------------------------| кровоизлияния.           | повреждений в           |--|
| Гадюки                     |                              | Тошнота, рвота.          | полости рта).             |  |
| (обыкновенная,         |                              | Иногда возбуждение,  | Введение                   |  |
| кавказская, носатая, |                              | судороги. Возможно    | специфической          |  |
| малоазиатская)         |                              | развитие коллапса по  | сыворотки                  |  |
|                                 |                              | типу                            | (антигюрза) или          |  |
|                                 |                              | анафилактического     | поливалентной           |--|
|                                 |                              | шока, гемолиза            | противозмеиной         |  |
|                                 |                              |                                    | сыворотки 500 АЕ      |  |
|                                 |                              |                                    | подкожно, в               |  |
|                                 |                              |                                    | подлопаточную          |  |
|                                 |                              |                                    | область. Введение     |  |
|                                 |                              |                                    | противостолбнячной  |--|
|                                 |                              |                                    | сыворотки (по            |  |
|                                 |                              |                                    | Безредке).                 |  |
|                                 |                              |                                    | Циркулярная              |  |
|                                 |                              |                                    | инфильтрационная     |  |
|                                 |                              |                                    | блокада 0,5%             |  |
|                                 |                              |                                    | раствором новокаина |--|
|                                 |                              |                                    | на 10—15 см              |  |
|                                 |                              |                                    | проксимальнее          |  |
|                                 |                              |                                    | места укуса.              |  |
|                                 |                              |                                    | Промывание ранки     |  |
|                                 |                              |                                    | 1% раствором калия  |  |
|                                 |                              |                                    | перманганата;            |  |
|                                 |                              |                                    | введение в ранку       |  |
|                                 |                              |                                    | 0,5 мл 0,1% раствора |  |
|                                 |                              |                                    | адреналина. Местно   |
|-----------------------------------------------------------------|                                    | холод.                       |--|
| Эфа песчаная          | Юг Средней Азии  |                                    | Иммобилизация         |  |
|                                 |                              |                                    | пораженной части      |  |
|                                 |                              |                                    | тела. Обильное          |  |
|                                 |                              |                                    | питье.                        |  |
|                                 |                              |                                    | Внутримышечно 2 мл |  |
|                                 |                              |                                    | 1% раствора              |  |
|-----------------------------------------------------------------|                                    | промедола, 1 мл        |--|
| Ямкоголовые змеи    | Северная и            |                                    | 2,5%                          |  |
| Гремучие змеи         | Южная Америка    |                                    | раствора аминазина,  |  |
|                                 |                              |                                    | 2 мл 1% раствора      |  |
|                                 |                              |                                    | димедрола.                |  |
|                                 |                              |                                    | Внутривенно              |  |
|                                 |                              |                                    | капельно 10 мл 10%   |  |
|                                 |                              |                                    | раствора кальция       |  |
|-----------------------------------------------------------------|                                    | хлорида, 15 000 ЕД    |--|
| Щитомордники          | Северная и            |                                    | гепарина (в стадии     |  |
|                                 | Центральная         |                                    | повышения                |  |
|                                 | Америка, Азия;      |                                    | свертываемости кро-  |  |
|                                 | Средняя Азия,       |                                    | ви). Внутримышечно  |  |
|                                 | Дальний Восток,    |                                    | гидрокортизон (до      |  |
|                                 | низовья Волги       |                                    | 300 мг в сутки). С      |  |
|                                 |                              |                                    | целью профилактики  |  |
|                                 |                              |                                    | вторичной инфекции  |  |
|                                 |                              |                                    | показаны                   |  |
|                                 |                              |                                    | антибиотики. В           |  |
|                                 |                              |                                    | тяжелых случаях       |  |
|                                 |                              |                                    | форсированный         |  |
|                                 |                              |                                    | диурез с введением   |  |
|                                 |                              |                                    | 250—400 мл 4%         |  |
|                                 |                              |                                    | раствора натрия        |  |
|                                 |                              |                                    | гидрокарбоната;         |  |
|                                 |                              |                                    | гемосорбция              |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
|                                 |                              |                                    |                                  |  |
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При пероральном отравлении пострадавшему следует незамедлительно промыть желудок через зонд (см. Промывание желудка) или дать выпить 2—3 стакана теплой подсоленной воды и вызвать рвоту (процедуру повторяют 3—4 раза). После промывания желудка дают сорбенты: активированный уголь (10—15 таблеток или 80—100 г водной взвеси) либо 80—100 г сухарей из черного хлеба.
При укусах ядовитых насекомых (пчел, ос, шмелей и др.) прежде всего необходимо удалить пинцетом жало с пузырьком, наполненным ядом, после чего промыть ранку спиртом. На место укуса рекомендуется холод (лед). При тяжелой интоксикации показаны антигистаминные препараты, кортикостероиды, витаминные препараты, обильное питье; при множественных укусах — циркулярная инфильтрационная новокаиновая блокада мест укусов. В тяжелых случаях пострадавшего необходимо экстренно госпитализировать.
При укусах скорпионов, пауков, змей необходимо выдавить из ранки первые капли крови и ртом отсосать яд (у оказывающего помощь не должно быть свежих повреждений в полости рта). Сплюнув яд, тщательно прополоскать рот водой. Ранку промыть 1% раствором калия перманганата. Не рекомендуется прижигать место укуса, делать надрезы или накладывать жгут при укусе в конечность. Это может вызвать серьезные осложнения. Пораженную конечность следует по возможности иммобилизировать путем шинирования с захватом ближайшего к месту укуса сустава.
Основным мероприятием неотложной медицинской помощи при укусах ряда Я. ж. является введение специфической моно- или поливалентной сыворотки. В случаях укусов змей используют сыворотки антигюрза, антикобра, а также поливалентную противозмеиную сыворотку широкого спектра специфического и неспецифического обезвреживающего действия. Сыворотку вводят однократно, желательно не позднее суток с момента укуса (в дальнейшем ее эффективность значительно снижается); в тяжелых случаях необходимо повторное введение сыворотки. При укусах змей обязательно вводят также противостолбнячную сыворотку. При укусах пауков применяют противокаракуртовую сыворотку, скорпиона — противоскорпионовую. Если вид ядовитого членистоногого неизвестен (или нет гомологичной сыворотки), можно использовать гетерологичные сыворотки, в т.ч. противозмеиную. Ее же применяют при укусе ящерицы ядозуба. Во всех случаях подобных отравлений пострадавшего необходимо экстренно госпитализировать (транспортировать на носилках!) для проведения комплексного лечения.
При невозможности экстренной госпитализации пострадавшего следует уложить (желательно в постель), придав возвышенное положение пораженной части тела, ввести антигистаминные препараты (1 мл 1% раствора димедрола подкожно или 0,05 г внутрь), внутривенно 10 мл 10% раствора кальция хлорида (кальция глюконата). Показано обильное питье (чай, кофе). При снижении АД подкожно вводят 2 мл кордиамина, 1 мл 20% раствора кофеин-бензоата натрия.
Методы специфической терапии разработаны для лечения острых отравлений ядами скорпионов, пауков и змей. При отравлениях другими зоотоксинами проводят симптоматическую терапию. В частности, в тяжелых случаях ожогов (например, при прикосновении к медузам), уколов ядовитыми иглами, шинами и др. применяют антгистаминные препараты (димедрол, пипольфен, супрастин). Эти же препараты, а также преднизолон (до 500 мг в сутки) используют при отравлениях животными ядами белковой природы, вызывающими явления анафилаксии. Как средство симптоматической терапии эффективен гепарин, применяемый для профилактики и лечения тромбогеморрагического синдрома. При развитии токсической миастении проводят искусственную вентиляцию легких (Искусственная вентиляция лёгких). Для профилактики и лечения инфекционных осложнений применяют главным образом антибиотики. Лечение местные воспалительных процессов состоит в локальной гипотермии и наложении антисептических повязок. При необходимости проводят некрэктомию.
Детоксикационная терапия в условиях стационара заключается в проведении форсированного диуреза и течение 2—3 сут. При тяжелом токсикозе (особенно у детей) показана Гемосорбция, в редких случаях развития печеночно-почечной недостаточности — Гемодиализ в сочетании с гемосорбцией. Детоксикационный эффект достигается также при внутривенном введении растворов альбумина и гемодеза.
Профилактика отравлений зоотоксинами определяется видом ядовитого животного. Основными мерами профилактики отравлений ядами активно-ядовитых животных являются знание их внешнего вида, особенностей поведения, а также соблюдение определенной осторожности в местах обитания этих животных. Следует подчеркнуть, что Я. ж. нападают на человека в подавляющем большинстве случаев вследствие его неправильного поведения, воспринимаемого этими животными как угроза нападения. Основные меры профилактики отравлений токсинами пассивно-ядовитых животных — см. Пищевые отравления.
Все учреждения и организации, занимающиеся отловом, искусственным разведением или изучением Я. ж., все медицинские учреждения (больницы, поликлиники, амбулатории, фельдшерско-акушерские пункты, здравпункты), расположенные в регионах естественного обитания Я. ж., должны постоянно иметь в наличии набор протавозмеиных сывороток (моно- и поливалентных), а также противокаракуртовую и противоскорпионовую сыворотки. Необходимо иметь в виду, что срок действия указанных сывороток строго ограничен.
Библиогр.: Орлов В.Н. и Вальцева И.А. Яды змей, Ташкент, 1977; Султанов М. Н Укусы ядовитых животных, М., 1977; Ядовитые животные Средней Азии, под ред. Г.С. Султанова, с. 270, Ташкент, 1970.
IIЯдови́тые живо́тные
Ядовитыми являются животные, в организме которых постоянно или периодически содержатся вещества, токсичные для человека и представителей других видов. Различают активно- и пассивно-ядовитых животных. Активно-ядовитые животные имеют специализированные железы, которые вырабатывают яд, служащий для защиты от врагов. У многих Я. ж. ядовитые железы связаны с ранящим аппаратом, такие животные используют яд и для нападения на жертву. У пассивно-ядовитых животных токсичные вещества содержатся в различных тканях или органах.
Из опасных для здоровья человека Я. ж. на территории нашей страны можно выделить некоторые виды змей (Змеи), насекомых (осы, пчелы, шмели и др.). Ядовиты также каракурты, скорпионы, тарантулы и некоторые другие виды членистоногих. Из обитателей водной среды ядовитыми являются отдельные виды морских рыб (например: скаты-хвостоколы, морские дракончики), кишечнополостных (медуза-крестовик, медуза Цианея, корнеротая медуза). Пресноводные рыбы ряда видов, обычно неядовитых (например: щука, судак, окунь, налим, угри), способны при определенных условиях приобретать ядовитые свойства. Ядовитыми свойствами обладают некоторые земноводные (жабы зеленая и обыкновенная, или серая, лягушка-жерлянка, а также саламандра).
Каракурт — один из опаснейших представителей паукообразных. Зона обитания каракурта охватывает южные районы страны. Иногда каракурты встречаются и в Подмосковье. Яд каракурта в 15 раз сильнее яда гремучей змеи и в 50 раз — яда тарантула. Причем ядовиты и молодые животные, и самцы. На месте укуса появляется маленькое, темное, быстро исчезающее пятно. Через несколько минут развивается отек, появляются сильные боли, распространяющиеся на конечности, поясницу, грудь, живот, отмечается резкое напряжение мышц брюшного пресса. В дальнейшем наступает озноб, повышается температура тела, возможны обильное потоотделение, выраженное возбуждение, галлюцинации, страх смерти, подергивания различных мышц, тошнота, рвота, затруднение дыхания и внезапная его остановка.
Первая помощь при укусе каракурта включает выдавливание из ранки первых капель крови и отсасывание яда ртом (у оказывающего помощь не должно быть свежих повреждений в полости рта). Ранку следует обработать 1% раствором марганцовокислого калия. Местно прикладывают холод. Пораженную конечность обездвиживают. При нарушениях дыхания проводят Искусственное дыхание. Во всех случаях необходимы госпитализация больного и введение специальной противокаракуртовой сыворотки (в подлопаточную область, а при тяжелой интоксикации внутривенно).
Скорпионы обитают в зонах пустынь и полупустынь Средней Азии, Казахстана, в гористых местах Южного Крыма, на Кавказе. В месте укуса появляются боль, краснота, отек (образуется несколько пузырьков, наполненных жидкостью). У пострадавшего отмечаются тошнота, рвота, сонливость, озноб, головная боль, головокружение. Через 15—30 мин после укуса возможны судороги, нарастание одышки. Артериальное давление вначале повышается, затем падает. После улучшения состояния возможно возобновление симптомов отравления. В тяжелых случаях может наступить остановка дыхания.
Первая помощь включает выдавливание из ранки первых капель крови и отсасывание яда ртом, промывание ранки 1% раствором марганцовокислого калия, местно холод и иммобилизация пораженной конечности, введение противоскорпионовой сыворотки (при ее отсутствии — противокаракуртовой или сыворотки антикобра) подкожно, в подлопаточную область.
Тарантул является постоянным обитателем пустынных и полупустынных районов страны. В месте укуса виден его след, отмечаются острая боль, покраснение, распространенный отек. Пострадавший испытывает тяжесть во всем теле, сонливость, апатию. Артериальное давление вначале повышено, затем понижается. Через 5—6 ч состояние улучшается.
Первая помощь заключается в отсасывании яда. Целесообразно введение противокаракуртовой сыворотки, промывание ранки 1% раствором марганцовокислого калия. Местно холод, иммобилизация пораженной части тела. Как во всех случаях поражения от ядовитого животного, необходимо обеспечить госпитализацию больного.
Морские рыбы. К активно-ядовитым животным условно относятся скаты-хвостоколы (морской кот и красный хвостокол, которые обитают в Черном и Азовском морях, а также в южном Приморье) и морские дракончики (обитают в Черном и Балтийском морях). Их яд, попадая в тело жертвы (пострадавшего) из специального колющего аппарата (колющие плавники, шипы на хвосте или жаберной крышке), обычно вызывает резкую боль. Кожа вокруг ранки бледнеет, затем появляются краснота, синюшность, отек (иногда распространенный). В течение нескольких часов нарастают симптомы интоксикации: возникают тошнота, рвота, понос, головокружение, озноб, повышение температуры тела, иногда бред, судороги, потеря сознания.
Среди морских Я. ж. определенную опасность представляют некоторые представители кишечнополостных. Это различные медузы: медуза-крестовик (обитает преимущественно в морях Дальнего Востока и в Амурском заливе), корнеротая медуза (обитатель Черного и Охотского морей), медуза Цианея (обитатель прибрежной зоны северной части Тихого океана и морей Северного Ледовитого океана).
Клиническая картина отравления, вызываемого этими медузами, сходна: жжение, боль, отек, краснота, крапивница, боли в груди, животе, удушье, боли в суставах и мышцах, подергивания мышц, мышечная слабость.
Первая помощь: промывание пораженного участка проточной водой с мылом. Местно — питательный крем на жировой основе.
Пресноводные рыбы. Ядовитые свойства пресноводные рыбы (большинство из них являются объектами рыбной ловли) приобретают, когда они начинают питаться пищей с ядовитыми свойствами или содержащей вещества, которые в процессе пищеварения приобретают эти свойства. Например, некоторые рыбы (щука, судак, налим, окунь, угорь) при определенных условиях становятся ядовитыми. Употребление в пищу этих рыб вызывает острое отравление — Юксовско-сартланскую болезнь. При этом (через 10—68 ч после употребления в пищу рыбы) человек испытывает резкие боли в мышцах конечностей, поясницы, грудной клетки. Боли усиливаются при малейшем движении, в тяжелых случаях распространяются практически на все скелетные мышцы. Появляются мышечная слабость, сухость во рту, иногда рвота. Моча красно-коричневого цвета (в тяжелых случаях почти черная). Болевой приступ длится от 3 ч до 4 сут., затем боли стихают, моча приобретает нормальную окраску. В тяжелых случаях развивается острая почечная недостаточность.
Первая помощь включает Промывание желудка через зонд, обильное питье, тепло. При появлении первых признаков отравления больного следует госпитализировать.
Другие виды водных организмов. Известны случаи отравления при употреблении в пищу некоторых видов иглокожих, в частности голотурий (морских огурцов), морских ежей и звезд. Отравление происходит при употреблении в пищу съедобных видов голотурий (трепангов) с не полностью удаленными внутренностями. Яд морских ежей и звезд вызывает главным образом местную реакцию — жжение, боль, зуд, отек в месте укола специализированными ядовитыми иглами. Сильнодействующий яд тетродотоксин, поражающий центральную и периферическую нервную систему человека, содержится во внутренних органах, икре, молоках и коже многих рыб отряда иглобрюхообразных, а также в икре, молоках и печени некоторых пресноводных рыб (например: усача, маринки) в период нереста.
Первая помощь в таких случаях оказывается так же, как и во всех случаях пищевого Отравления.
Земноводные. Ядовиты саламандры, жабы, жерлянки. Ядовитые железы у этих животных расположены в различных участках кожи; при возникновении угрозы нападения ядовитый секрет этих желез тончайшими струйками выбрасывается на поверхность кожи. Яд саламандр оказывает нейротоксическое действие. Яд жаб оказывает местное раздражающее действие на кожу и желудочно-кишечный тракт (при попадании ядовитого секрета внутрь), а также кардиотоксическое действие.
Первая помощь заключается в промывании пораженного участка проточной водой с мылом и последующем наложении на этот участок слоя гидрокортизоновой мази и анестезина. При попадании яда внутрь показаны промывание желудка через зонд, внутрь солевое слабительное, активированный уголь, обильное питье, обволакивающие средства.
См. также Укус животного.
Шмель
Шмель.
Медуза Цианея
Медуза Цианея.
Тарантул
Тарантул.
Скорпион
Скорпион.

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