南京“5．7”放射事故患者受照后2年的医学观察  

Medical follow-up of the exposed victim two years after ＂5.7＂ radiation accident in Nanjing

作　　者：刘松涛[1] 刘玉龙[2] 王优优[2] 卞华慧[2] 陈炜博[2] 刘华江[2] 侯雨含 崔冉[2] 王睿昊[2] 

机构地区：[1]苏州大学附属第二医院超声中心,215004 [2]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》2017年第6期420-425,共6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：目的通过对2014年南京“5．7”^192Ir源放射事故患者受照后2年的医学观察，探讨放射损伤的远后效应及肢体局部放射损伤的康复治疗效果，为核与辐射事故医学应急提供临床资料。方法仔细询问受照患者的病史，进行详细的体格检查，观察和记录临床症状和体征，系统评价其血液系统、免疫系统、生殖系统、眼、神经一精神系统等改变，观察并评价患者右下肢功能障碍的康复治疗疗效。结果造血、免疫系统基本恢复，但骨髓穿刺仍提示右侧髂骨骨髓增生低下。性激素水平在正常范围内，但精液检查显示精子活率为0。眼晶状体、视网膜及眼底均出现放射性损伤。心理测评显示，患者心理状态较稳定。右下肢皮肤伤口愈合良好，但仍有功能障碍及疼痛感，通过康复治疗后功能障碍较前好转，药物结合物理疗法镇痛效果良好。结论临床治疗尽早干预可使轻度骨髓型急性放射病患者的生理功能完全或部分恢复。Objective To investigate the late effects induced by ionizing radiation and the rehabilitation treatment of local radiation injury by medical follow-up of the patient exposed to ^192 Ir at ＂5.7＂ accident in Nanjing, and to provide more experience for the treatments in the medical emergency of nuclear or radiological accident. Methods According to the history inquiry and physical examination of the patient in detail and the record of clinical symptoms and signs, the changes of the blood system, immune system, reproductive system, eyes, nervous system were systematically evaluated. The effects of rehabilitation treatment for the patient with lower limb dysfunction were also assessed. Results After the medical treatments of the patient, the hematopoietic immune system was restored, but the bone marrow aspiration still showed low bone marrow hyperplasia in right ilium. Meanwhile, the level of sex hormones was within the normal range, but semen examination showed sperm motility was O. The radiation damage also occurred in the eye lens,retina and fundus. However, the psychological evaluation showed that the patient was stable and the right lower limb skin wound healing was well except for dysfunction and pain in some extent, which was relieved after the rehabilitation treatment. Conclusions The physiological function of the exposed victim with mild bone marrow type acute radiation sickness could be completely or partially restored after the clinical treatment in the early stage.

关 键 词：放射事故 骨髓型急性放射病 ^192IR 远后效应 医学随访 

分 类 号：R818[医药卫生—放射医学]