一起放射事件中2例^(131)Ⅰ体内合并体表污染人员的应急医学处理  

Medical Treatment of Two Cases With Internal Contamination Combined with Skin Contamination of ^(131)Ⅰ

作　　者：姜忠[1] 刘玉龙[1] 蒲汪旸[1] 李元[1] 张玉松[1] 戴宏[1] 周丽英[1] 

机构地区：[1]苏州大学附属第二医院中国核工业辐射损伤医学应急中心,江苏苏州215004

出　　处：《苏州大学学报（医学版）》2010年第1期94-97,共4页Suzhou University Journal of Medical Science

摘　　要：目的通过对一起放射事件中2例131Ⅰ体内合并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和管理提供资料和经验。方法采用全身测量装置进行放射性监测,通过INDO2000软件进行剂量估算;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,医学随访观察4年未见明显异常。结论成功地对2例131Ⅰ体内合并体表污染人员进行了剂量估算、医学处理及医学随访,为核事故医学应急作出了技术准备。Objective To introduce the accident course and clinical characteristics of two cases with internal contamination combined with skin contamination of 131I , 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 inquiring and physical examination, decontamination of contaminated skins and combined therapies. The laboratory ex- amination of routine examination, tumor markers, and conventional chromosome aberration and micronu- cleus 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 separate dose equivalents of hypothyroid for them. Decontamina- tion and combined therapies were effective methods and there was no obvious abnormity in a 4-year medi- cal follow-up. Conclusion Dose estimation, medical treatment and follow-up study for two cases with an internal-and-skin combined contamination of 131I 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：R818.74[医药卫生—放射医学]