一起辐射探伤事故中6名疑似受照人员的医学观察  

Medical observation of six suspected irradiated staff members in a radiological accident

作　　者：王敏[1] 刘玉龙[1] 卞华慧[1] 王优优[1] 王睿昊[1] 侯雨含 崔冉[1] 杜云 姚振 Wang Min;Liu Yulong;Bian Huahui;Wang Youyou;Wang Ruihao;Hou Yuhan;Cui Ran;Du Yun;Yao Zhen(Department of Oncology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China215004, China)

机构地区：[1]苏州大学附属第二医院肿瘤科,215004

出　　处：《国际放射医学核医学杂志》2019年第2期119-124,共6页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的通过对一起辐射探伤事故中6名疑似受照人员的临床表现、外照射剂量估算及医学处理的总结,探讨事故成因及后果,为今后类似实践提供技术参考。方法疑似受照人员6名,结合病史问诊、体格检查及实验室检查分析其外周血淋巴细胞染色体“双着丝粒+环”畸变及外周血淋巴细胞微核;采用直接测量法估算物理剂量,计算累积剂量;采用焦虑自评量表、抑郁自评量表及卡特尔16项人格测验量表对疑似受照人员进行心理测试,评估其综合心理素质。结果6人临床表现上均有不同程度的不适主诉,体格检查未见明显异常,辅助检查发现几项异常结果,但均与辐射损伤无明显相关;有1人染色体分析细胞数1400中可见1个双着丝粒体,其余均未见异常畸变;物理剂量估算提示周围剂量当量率最大值为20.15mSv/h,辐射累积剂量为0.67mSv;心理测评结果表明有3名人员存在不同程度的焦虑与抑郁状态。结论6名疑似受照人员的各项结果均与电离辐射无关,均未受到急性大剂量电离辐射外照射,不会产生有临床意义的生物效应。Objective To discuss the cause and consequence of a radiological accident, where 6 staff members were suspected to be irradiated. Similar medical cases were included by focusing on clinical manifestations, external radiation dose estimation, and medical treatment. Methods Blood specimen was extracted from the 6 staff members to analyze the peripheral blood lymphocyte chromosomal aberration " dic+r" and micronucleus. Their personal medical histories were taken, and other auxiliary evaluations were conducted. The physical dose was obtained by directly calculating the cumulative dose. The psychological test on the 6 staff members was based on the Anxiety Self- Assessment Scale (SAS), Depression Self-Assessment Scale (SDS), and Eysenck Personality Questionnaire (16PF). Results The staff members all reported complaints. Physical examination showed no obviously associated anomalies, and several abnormal results revealed in the auxiliary examination were not remarkably correlated with the radiological accident. In the biological dose estimation," 1dic" was found in 1400 cells in the chromosome analysis of one staff member. No abnormal aberration was found among the rest. The physical dose estimation indicated that the maximum value of the surrounding dose equivalent rate was 20.15 mSv/h, whereas the cumulative radiation dose was 0.67 mSv. The psychological assessment showed that 3 of the 6 staff members had different degrees of anxiety and depression. Conclusion Based on the results of clinical manifestations, biological and physical dose estimation, as well as the psychological test, the 6 staff members were not ionizing-irradiated and no clinically significant biological effect occurred.

关 键 词：辐射 电离 辐射损伤 辐射剂量 医学处理 

分 类 号：R818[医药卫生—放射医学]