关键词：骨髓型急性放射病；辐射剂量；60 Coγ射线；放射事故
目的 为了总结临床经验，本文作者报告一起60 Coγ射线事故引起4人受照的剂量估算、临床经过和诊断治疗。方法 剂量估算是采用现场模拟试验和手表红宝石热释光测量，外用血染色体畸变率、微核率分析方法。临床诊断根据患者受照剂量，临床表现和实验室结果进行综合分析，治疗上在对症治疗和综合治疗的基础上，应用了美国生产的GM-CSF。结果 1例中度(偏重)骨髓型急性放射病，1例中度骨髓型放射病，1例轻度骨髓型急性放射病，1例过量照射，4例病人经过62/68天住院积极治疗，病情好转，取得了良好的治疗效果。结论 从医疗实践中我们着重总结以下几点：①及时、正确地早期诊断；②根据国家标准的治疗原则积极治疗；③GM-CSF使用时注意选择时机和注意使用方法，才能取得良好的疗效。
Clinical report of fourcases of acute radiation sickness in a 60 Co radiation accident in Wuhan .Li Meiying,Zhang Yaozhen,Zhang Donghua,et al,Tongji Hospital of Tongji MedicalUniversity,Wuhan 430030,China.
Objective To sum up clinical experience from assessment of radiation dose,clinicalcourse,diagnosis and treatment of four cases of acute radiation sickness (ARS) in a 60 Coradiation accident on 13 Nqovember,1992,in Wuhnn,China.Methods Radiation doses wereassessed by simulation test of accident site,thermoluminescent dosimetry of ruby,andanalysis of chromosome aberraqtion and micronuclear rates in peripheral blood.Diagnosiswas based on analysis of irradiation doses,clinical manifestations and laboratoryresults.In therapeutical aspect GM-CSF was administered on the basis of comprehensivetreatment.Results Four cases of ARS,including 1 case of moderate degree on the severeside,1 case of moderate degree and 1 case of mild degree bone marrow form,as well as 1case of overexposure,were meticuslously treated for 62 to 68 days.The patients'conditonstook favourable turn.The therapeutic effects were good.Conclusion From the clinical pointof view we stress that (1) as soon as it is possible to estimate the degree of severity ofARS accurate diagnosis should be made;(2) early comprehensive treatment should be givenaccording to the therapeutic principles of National Standard GB8280-87;(3)to improve thecurative effect GM-CSF should be given at the right time.
Key words Bone marrow from Acute radiation sickness Radiation dose Cobalt-60 γ -rays Radiation accident
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