两例^131I体内、体表污染人员的医学处理  

Medical treatment of two cases with internal contamination combined with skin contamination of ^131 I

作　　者：刘玉龙[1] 蒲汪旸[1] 包雍镝[1] 李元[1] 张玉松[1] 戴宏[1] 周丽英[1] 周剑影[1] 

机构地区：[1]苏州大学附属第二医院,215004

出　　处：《中华放射医学与防护杂志》2008年第5期459-461,465,共4页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的通过对2例^131I体内、体表污染人员的事故经过、临床特点、剂量估算、临床救治及医学随访观察结果的报道，为类似病例的医学应急救治提供资料和经验。方法采用全身测量装置进行放射性监测，通过INDO2000软件进行估算剂量；医学处理包括问诊与体检、污染部位皮肤的去污洗消及综合治疗等；医学随访项目包括常规检查、肿瘤标志物检测、染色体畸变及微核分析等。结果INDO2000软件估算出2例事故受照人员的待积有效剂量分别为0．10～0．19Sv及0．023～0．046Sv，甲状腺的待积当量剂量分别为2．0～3．8Sv及0．46～0．89Sv。对他们进行去污洗消及综合治疗取得了较好的疗效，4年的医学随访观察未见明显异常。结论成功地对2例^131I体内、体表污染人员进行了剂量估算、医学处理及随访观察。Objective To introduce the accident course and clinical characteristics of two cases with internal contamination combined with skin contamination of ^131 I, and to present the dose estimation, medical treatment and their follow-up study which will be helpful for the similar cases in medical emergency. Methods Whole body count measurement apparatus was used for radioactivity monitoring and dose was estimated and calculated by using INDO 2000 software. Medical treatment included asking and physical examination, decontamination of contaminated skins and combined therapies. The laboratory examination of routine examination, tumor markers, and conventional chromosome aberration and mieronucleus analysis were included in medical follow-up. Results The committed effective doses evaluated by INDO 2000 software were 0.10-0.19 Sv and 0.023-0.046 Sv for two cases respectively. 2.0-3.8 Sv and 0.46-0.89 Sv were the committed doses equivalent of hypothyroid for them separately. Decontamination and combined therapies were effective methods and there was no obvious abnormity in a 4-year medical follow-up. Conclusions Dose estimation, medical treatment and follow-up study for two cases with an internal-and-skin combined contamination of ^131 I has been properly performed.

关 键 词：^131I 体内污染 体表污染 剂量估算 医学处理 

分 类 号：R144[医药卫生—公共卫生与预防医学]