关键词：放射事故，急性放射病，妊娠，GM-CSF
目的 通过对诊断不明病人“芳”的诊断和治疗，探索在放射源不明情况下，如何进行放射病的诊断，探索采用简易隔离和GM-CSF治疗效果；同时回顾性介绍同组其他病人发病经过。方法 通过详细询问病史，排除传染病和中毒，在高度怀疑放射病时，经对外周血淋巴细胞染色体畸变分析，确诊急性放射病；复习文献，提出放射源不明、放射病诊断线索。结果 经作淋巴细胞染色体畸变分析，估算受照剂量为2.30(2.07～2.50)Gy，确诊为骨髓型急性(中度)放射病，同时推断家中死亡3例也为放射病。结论 如遇到难以解析的皮肤烧伤病变(红斑，水泡)，排除热或化学烧伤后，应考虑放射烧伤，对有恶心，呕吐，脱发，口腔溃疡，外周血细胞减少者，更支持诊断；如家中成员中相继发生上述同类症状者更应高度怀疑，并作相关检查确诊；简易隔简可为一般医院所采用；细胞因子可促进造血功能恢复，缩短病程。
Clinical report of eightchief victims in 60Co radiation accident in Xinzhou. Lou Bincheng,DingXiulan,Zhang Yaochen,et al.Department of Emergency Medicine,People's Hospital,BeijingMedical Unversity,Beijing 10044,China.
Objective This paper present the clinical diagnosis and treatment of one patient (Feng) with acuteradiation sickness(ARS) without obvious history of radiation exposure,the therapeuticeffect of simple isolation and administration GM-CSF and the condition of other sevenpatients in this group.Methods After colleoting detailed history and chromosome aberrationanalysis of lymphocytes,a definite diagnosis of ARS was made and infectious diseases andpoisoning were ruled out.Results When feng was recovered with GM-CSF and simple iselation143 rings plus dicentric aberrations were found in 300 lymphocytes with intermitotic phase0.4368 “ R+Dic ” exist averagely in everycell,the whole body dose was esimated to be 2.3Gy.Thus,acute radiation sickness ofmoderate degree was ascertained.It was deduced that 3 other members in Feng's family diedof ARS.Altogether about 100 victims were found.Conclusion When evaluating a patient withsuspicious burn(erythema,blistering) without a history of contact of heat or fire andcaustic chemicals and the patient has nausea,vomiting,epilation and decrease in whiteblood cells,the possibility of radiation exposure exists.If some patients with abovemanifestations are found in a same family the radiation exposore may be more probable.Asimple isolation ward can be set in an ordinary hosiptal and GM-CSF is used to reduce thecourse.
Key words Radiation accident Acute radiation skckness GM-CSF
1 事故经过
山西省忻州民工“昌” ......
您现在查看是摘要页，全文长 16152 字符。