1例^(192)Ir源致外照射轻度骨髓型急性放射病的临床观察与随访  

Medical follow-up and clinical observation of a case exposed to ^(192)Ir source with mild bone marrow from of ARS

作　　者：卞晓璐 韩贞琳 张晓强 杨奕 BIAN Xiaolu;HAN Zhenlin;ZHANG Xiaoqiang;YANG Yi(The Second Hospital of Heilongjiang Province,Harbin 150010 China)

机构地区：[1]黑龙江省第二医院,黑龙江哈尔滨150010

出　　处：《中国辐射卫生》2018年第4期318-321,共4页Chinese Journal of Radiological Health

摘　　要：目的对2005年哈尔滨"7. 13"^(192)Ir源放射事故受照者1例进行临床观察与12年的医学随访,探讨外照射轻度骨髓型急性放射病的临床治疗及远后效应。方法详细采集患者病史,收集临床资料,从血液系统改变、心理健康等方面进行总结,评价治疗效果,观察远后效应。结果早期治疗后,患者造血系统改变、心理创伤、无力综合征、神经衰弱综合征均有所改善,受照后第10年患者开始出现粒系、红系、巨核细胞系同时减少,受照后第13年被诊断患有分离转换障碍,病程中还伴有心力衰竭、肝功异常、免疫力低下、神经衰弱等疾病。治疗后可缓解症状,但易反复。结论本例轻度骨髓型急性放射病在临床表现与远后效应上有其独特的疾病特点,并发症较多,为今后此类疾病的临床救治提供了参考。Objective To investigate the clinical treatment and late effects of mild bone marrow form of acute radiation sickness after 12 years of medical follow-up and clinical observation in a case of ＂7.13＂（192）Ir accident in Harbin in 2005. Methods Collect the patient＇s history,In detail collect the clinical data,summarize the changes of hematopoietic system and mental health,evaluate the therapeutic effect and observe the late effects. Results After early treatment,the changes of hematopoietic system,psychic trauma,asthenic syndrome and neurasthenia syndrome were all improved. After the first 10 years of exposure,the patient began to experience a decrease in granulocytic system,erythrocyte system,and megakaryocytic system. In the 13 th year,the patient was diagnosed with dissociative disorder,heart failure,hepatic Insufficiency,low immunity,neurasthenia and so on. Symptoms can be relieved after treatment,but easy to repeat. Conclusion This case of mild bone marrow form of acute radiation sickness has its unique characteristics and complications in clinical manifestations and late effects,which provides a reference for the clinical treatment of these diseases in the future.

关 键 词：^192IR 外照射轻度骨髓型急性放射病 造血系统 精神系统 远期效应 

分 类 号：R818[医药卫生—放射医学]