河南“4.26”60Co源辐射事故患者早期分类诊断及医学处理

目的：总结1999年4月26日河南发生的^60Co源辐射事故中7名受照者的早期分类诊断和医学处理，探讨类拟辐射事故的医学急处理，方法：根据生物剂量和物理剂量的估算，受照者照后初期的临床症状和体征，照后外周血白细胞和淋巴细胞的变化做出初步诊断，并采用相应的救治措施，结果：7例受照者的初期诊断与诊床诊断一致，正确的早期分类诊断和医学处理有利于制定救治方案，判断预后，使患者顺利度过极期，结论：早期分类诊断应综合分析患者照后出现的症状，体征，外周血白细胞和淋巴细胞的变化，初期症状的发生尤其是哎吐开始的时间和严重程度不但与受照剂量有关，也受剂量率，受照部位，不均匀程度和个体差异等因素的影响，生物剂量和物理剂量的估算是早期分类诊断的基础，发生事故后应尽早开始。

Early classification diagnosis and medical handling in seven cases having survived from the Henan 60Co radiation source accident.

Objective This article summarizes the early classification diagnosis and medical handling of seven cases who survived from the Henan ⁶⁰ Co radiation source accident occurred on April 26,1999 in order to approach the medical support in similar radiation accident in the future. Methods The preliminary diagnoses were made by the estimation of physical and biological doses,the early clinical symptoms and signs,and the changes in leucocytes and lymphocytes of the seven cases post irradiation.In the meantime,the treatment measures were taken. Results The initial diagnoses were consistent with the clinical diagnosis for the seven cases.The correct measures adopted including early classification diagnosis and medical handling were beneficial to making treatment plan,judging the late consequences,and helping the patients pull through the critical period without a hitch. Conclusion The symptoms,signs,and changes in leucocytes and lymphocytes in patients post irradiation should be synthetically analyzed in the early classification diagnosis of radiation damages.The initial symptoms,especially in the early time,and the severity of vomiting are not only related to the irradiation doses,but are also affected by the dose rate,the location and inhomogeneity of the radiation,and the individual variation.Because the early classification diagnosis is mainly based on the estimation of physical and biological doses,the dose estimation should be performed as early as possible after the accident.