核应急医学救援中放射性核素污染伤口的医学处理思考  

A reflection on medical treatment of radionuclide-contaminated wounds during medical response to nuclear emergencies

作　　者：吕晓凡 卢丙慧 冉新泽[1] 王军平[1] 王涛[1] LYU Xiaofan;LU Binghui;RAN Xinze;WANG Junping;WANG Tao(State Key Laboratory of Trauma,Burns and Combined Injury,Department of Anti-radiation Medicine,Institute of Combined Injury,School of Preventive Military Medicine,Army Medical University(Third Military Medical University),Chongqing 400038 China)

机构地区：[1]陆军军医大学(第三军医大学)军事预防医学系防原医学教研室,全军复合伤研究所,创伤、烧伤与复合伤国家重点实验室,重庆400038

出　　处：《中国辐射卫生》2023年第4期402-407,412,共7页Chinese Journal of Radiological Health

基　　金：陆军军医大学教育训练改革研究课题(2022B07);军队后勤科研项目(ZLJ22J020)。

摘　　要：伤口放射性核素污染是核应急医学救援中的常见问题,在不同的事故类型中表现形式各具特点,其医学处理是救援中的重点内容。结合自身参加核应急医学救援演训的实践经验,笔者梳理了近年来放射性核素污染伤口的研究进展,主要涉及放射性核素污染伤口后的生物动力学特点、医学应急处理、手术清创、内污染防治等,对技术操作层面的要点进行了归纳,对演训中有待改进之处提出了建议。笔者认为放射性核素污染伤口的医学处理需要临床医学实践技能与放射医学知识的高度兼容综合,应急处理、手术清创、内污染防治等处置构成具有内在逻辑关联的一体救治策略,而要想达到理想的效果则需要在演训中有的放矢地进行改进。Radionuclide-contaminated wounds are common in medical response to nuclear emergencies,which have different manifestations in different types of accidents.Medical treatment is the key part of the response.Based on the drill experience gained from medical response to nuclear emergencies,the authors summarize the research advances in radionuclidecontaminated wounds in recent years,mainly involving the biokinetic characteristics,medical response,surgical debridement,and prevention and treatment of internal contamination of radionuclide-contaminated wounds;the authors summarize the key points of technical operations and provide suggestions on improvements in the drills.The authors believe that medical treatment of radionuclide-contaminated wounds requires highly compatible integration of the practical skills from clinical medicine and radiological knowledge;emergency response,surgical debridement,and prevention and treatment of internal contamination all together constitute an integrated rescue and treatment strategy with internal logic correlations.However,targeted improvements are needed to achieve desired effects in the drills.

关 键 词：放射性核素污染伤口 核应急医学救援 放射性内污染 手术清创 促排治疗 

分 类 号：TL73[核科学技术—辐射防护及环境保护]