南京“5．7”^192Ir源放射事故患者的神经行为及心理健康改变  

Nervous behavior and mental health changes in a case exposed to ^192Ir source at ＂5.7＂ accident in Nanjing

作　　者：陈炜博[1] 刘玉龙[1] 卞华慧[1] 王优优[1] 李元[1] 郑旭[1] 包明月[1] 郭凯琳[1] 

机构地区：[1]苏州大学附属第二医院应急中心,215004

出　　处：《中华放射医学与防护杂志》2016年第5期372-376,共5页Chinese Journal of Radiological Medicine and Protection

基　　金：江苏省临床医学科技专项（BL2014040）;江苏省卫生计生委2014-2015年度预防医学科研项目（Y2015024）

摘　　要：目的 结合南京＂5.7＂192Ir源放射事故患者的救治过程,探讨辐射损伤导致的神经行为及心理健康改变。方法 采用＂一对一＂、＂多对一＂的方法密切观察并记录患者精神状态变化,给予心理干预及药物治疗;采用卡特尔16种个性因素测验（16PF）、抑郁自评量表（SDS）、焦虑自评量表（SAS）对患者进行心理测评;采用简短精神状态量表（MMSE）、蒙特利尔认知评估（MoCA）北京版对患者进行认知功能评估。结果 患者住院期间出现紧张、畏惧、烦躁等表现,心理测评结果显示,其有焦虑、抑郁、烦恼等情绪,经过积极心理疏导、并给予舍曲林、奥氮平治疗后精神状况改善;认知功能评估结果显示,其一度出现中重度认知功能障碍,随着全身情况的好转,认知功能逐渐恢复正常。3次MMSE测试结果分别为14、26和28分,3次MoCA测试结果分别为10、20和27分。结论放射损伤患者临床救治过程中应注重躯体治疗与心理治疗的同步,心理改变经过合理干预和治疗可改善,神经行为改变原因仍有待进一步研究。Objective To explore the changes in nervous behavior and mental health caused by radiation damage, and to provide clinical data and experience for the similar cases, based on the treatment process of the patient exposed to Iridium-192 source accident in Nanjing, Methods The changes in the mental status of the patient was observed closely in a manner of ＂one to one＂, or ＂several to one＂, gave psychological intervention and drug treatment. The psychological evaluation for the patient was carried out by using Cattell 16 personality factors test （16PF）, self-rating depression scale （SDS） and self-rating anxiety scale（SAS）. The cognitive function assessment was carried out by using mini-mental state scale （MMSE） and Montreal cognitive assessment （MoCA） Beijing version. Results The patient showed tension, fear, upset, etc., in hospital, and psychological evaluation results showed that he had the emotions such as anxiety, depression and worry. The mental health was improved after a positive psychological counseling and treatment by using sertraline and olanzapine. Cognitive function assessment results showed that he had moderate-severe cognitive dysfunction for a time, which gradually returned to normal with the improvement of general condition. Conclusions Attention should be paid to the synchronization of physical therapy and psychological treatment in the process of clinical treatment of patients with radiation injury. Improvement to psychological problems is possible using reasonable intervention and treatment, and the cause of neurobehavioral changes still need further research.

关 键 词：^192IR 急性放射损伤 心理测评 心理干预 认知功能评估 

分 类 号：R818[医药卫生—放射医学]