2例^(192)Ir辐射事故受照人员的剂量估算和医学处理  

Dose estimation and medical treatment of 2 cases accidentally exposed to ^(192)Ir

作　　者：卞华慧[1] 刘玉龙[1] 陈炜博[1] 王优优[1] 戴宏[1] 蒲汪旸[1] 

机构地区：[1]苏州大学附属第二医院,江苏苏州215004

出　　处：《中国卫生检验杂志》2015年第12期1884-1887,共4页Chinese Journal of Health Laboratory Technology

基　　金：江苏省临床医学科技专项(BL2014040)

摘　　要：目的通过对一起192Ir辐射事故中2例外照射受照人员的剂量估算、医学处理的分析,为核与辐射事故医学应急救治提供资料和经验。方法采用热释光剂量计法估算物理剂量;染色体畸变、CB微核分析及HPRT基因位点突变频率分析法估算生物剂量;观察受照者的临床表现、免疫功能、精液常规、眼晶体、心理等变化。结果物理剂量估算,"陈"的全身平均吸收剂量为2.85 m Gy^88.50 m Gy、"宋"的全身平均吸收剂量为2.85 m Gy^64.05 m Gy;事故后2例受照者均有神经衰弱症状,"陈"CD8+细胞比率升高,"宋"NK细胞比率下降、精子活率和活力出现异常。"陈"发生急性放射性皮肤损伤Ⅱ度。心理测评显示,2例受照者均出现焦虑、抑郁。结论系统地对2例192Ir受照者进行了剂量估算、医学处理,为类似病例的处置提供借鉴。Objective To provide information and gain experience for medical treatment in nuclear accident emergencies,by the dose estimation and medical treatment of 2 cases exposed to192 Ir accidentally. Methods The physical dose was evaluated by thermoluminescent detector. Biological dose assessment was performed by the analysis of chromosomal aberrations,micronucleus（ CB method） and the frequency of HPRT locus mutation. The clinical manifestation,immune function,semen routine,eye crystal,psychological status,et al were observed. Results The general average absorbed doses for two cases were estimated to be 2. 85 m Gy- 88. 50 m Gy（ Chen） and 2. 85 m Gy- 64. 05 m Gy（ Song）,respectively. Two patients had syndrome of neurasthenia after exposure. The ratio of CD8＋cells increased in case Chen,and the rates of NK cells decreased in both of them. Sperm viability and motility were abnormal in the patients. Case Chen was diagnosed with degree Ⅱ acute radiation- induced skin injury. Psychological evaluation showed that both of the patients were with anxiety and depression. Conclusion Systematical dose estimation,and medical treatment for the two cases with192 Ir external irradiation can provide information for medical treatment of similar cases.

关 键 词：192IR 外照射 剂量估算 医学处理 

分 类 号：R818.7[医药卫生—放射医学]