| Wang Guilin,Luo Qingliang,Chen Hu,et al.Clinical report of a moderate degree bone marrow form of acute radiation sickness associated with local extremely severe radiation damage.[J].Chinese Journal of Radiological Medicine and Protection,1997,17(1):12-18 |
| Clinical report of a moderate degree bone marrow form of acute radiation sickness associated with local extremely severe radiation damage. |
| Received:May 03, 1996 Revised:September 04, 1996 |
| DOI： |
| KeyWords:Acute radiation sickness Local radiation damage rhG CSF Myocardiac enzyme Amputaion |
| FundProject: |
| Author Name | Affiliation | | Wang Guilin | Beijing North Taiping Road Hospital, Beijing 100039 | | Luo Qingliang | 北京放射医学研究所 | | Chen Hu | Beijing North Taiping Road Hospital, Beijing 100039 | | Ye Gengyao | Beijing North Taiping Road Hospital, Beijing 100039 | | 叶根耀 | Beijing North Taiping Road Hospital, Beijing 100039 | | 曹履先 | Beijing North Taiping Road Hospital, Beijing 100039 | | 王波 | Beijing North Taiping Road Hospital, Beijing 100039 | | 夏贞彪 | 北京放射医学研究所 | | 江岷 | Beijing North Taiping Road Hospital, Beijing 100039 | | 胡亮钉 | Beijing North Taiping Road Hospital, Beijing 100039 | | 秦茂权 | Beijing North Taiping Road Hospital, Beijing 100039 | | 杨文峰 | Beijing North Taiping Road Hospital, Beijing 100039 |
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| Abstract:: |
| Objective This paper presents the clinical diagnosis and treatment of a patient “Wen”subjected to an accidental 192Ir exposure in January 5,1996 in Jilin City.It is our hope to afford new experience and information for similar cases in the future.Methods After physical dose estimation,biological dosimetry from chromosome aberrations and micronuclei of lymphocytes and ESR estimation of bone samples were conducted.In addition to the dose estimation,the degree of whole body and local radiation damage was also judged by the clinical symptoms and signs,and changes in hemopoietic system.rhG-CSF was given on days 4-23.Results The hemopoietic stem cell survival weighted whole body dose was 2.9±0.3Gy and the maximal dose was 3737.8Gy in right leg.Frequent episodes of nausea and vomiting were observed about 3 hours after exposure.The lymphocyte counts were 0.9-0.4×109/L on day 1 to day 2.In order to save life,his right lower extremity and left wrist had to be amputated on day 8.The nadir of white blood cells and platelets were 0.65×109/L and 19×109 on day 17 post exposure,respectively.rhG-CSF was used for accelerating hematopoietic restoration,so that his critical stage lasted only for five days,followed by rapid recovery.Conclusion The study suggests that the local radiation damage might aggravate the total body condition so that the rational treatment of local damage should not be neglected in clinical practice.This is a case of moderate degree bone marrow form of acute radiation sickness associated with extremely severe local radiation damage.The early use of rhG-CSF is beneficial to hematopoietic restoration,while the myocardiac enzymes can be used in assessment of local radiation damage.The early amputation of extremely severe damaged limbs is the key to success. |
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