杨志祥,杨文峰,孙向黎,段翠密,胡莎莎,郑晓玲.一例192Ir极不均匀外照射局部极重度放射损伤的临床观察[J].中华放射医学与防护杂志,1997,17(1):19-21
一例192Ir极不均匀外照射局部极重度放射损伤的临床观察
Clinical observation of extremely severe local radiation injury by extremely heterogeneous 192Ir irradiation:report of a case
投稿时间:1996-05-03  修订日期:1996-09-04
DOI:
中文关键词:  192Ir放射源  放射损伤  临床观察  红外线热成像
英文关键词:192Ir radiation source  Radiation injury  Clinical observation  Infra red thermoimaging
基金项目:
作者单位
杨志祥 100039 北京北太平路医院 
杨文峰 100039 北京北太平路医院 
孙向黎 100039 北京北太平路医院 
段翠密 100039 北京北太平路医院 
胡莎莎 100039 北京北太平路医院 
郑晓玲 100039 北京北太平路医院 
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中文摘要:
      目的 对1例192Ir极不均匀外照射局部极重度放射损伤病人进行临床观察。方法 系统观察了病变的临床过程和应用红外线热成像技术测定了损伤部位的温度变化。结果 照射后2小时出现肢体麻木、抽搐,最早照后4小时出现红斑、肿胀,54小时出现水疱,第5天出现坏死和剧痛,最晚出现红斑、肿胀是照射后41天,47天出现水疱和糜烂创面。红外线热成像显示:损伤早期温度升高,水疱、坏死区和损伤后期温度降低,温度升高越早,损伤越重,温度改变区域与损伤范围相一致。结论 大剂量极不均匀外照射放射损伤的初期反应早,放射病与局部损伤相互加重病情,症状先后不一,轻重不等,致残率高和疼痛剧烈,红外线热成像温度变化可以作为临床诊断的指标之一。
英文摘要:
      Objective The clinical observation of a case of extremely severe local radiation injury by extremely heterogeneous external irradiation of 192Ir is reported.Method The clinical pathologic change was systematically observed,and the temperature changes in the radiation injured parts were examined by infra red thermoimaging.Results Numbness and convulsion occurred 2h after irradiation,the earliest erythema and swelling were found 4h after irradiation.Blistering took place 54th after irradiation,necrosis and severe pain occurred at the 5th day,the latest erythema and swelling were found 41days after irradiation,and blistering and erosive surface of wound took place at the 47th day.Infra red thermoimaging examination showed that temperature increased in the early stage of injury,while it decreased in blisters,necrotic regions and in the late stage of injury.The earlier the temperature increased,the severer the injury was.The region of temperature change was consistent with injury extent.Conclusion Incipient reaction occurred early,injury was exacerbated by radiation sickness and local injury,symptoms were different in early and late stages and varied in severity,the disability was high and pain was severe.The temperature change during infra red thermoimaging can be used as one of the objective indices for the diagnosis of injury extent and degree.
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