1例192Ir源致外照射轻度骨髓型急性放射病的临床观察与随访

目的 对2005年哈尔滨"7.13"¹⁹²Ir源放射事故受照者1例进行临床观察与12年的医学随访，探讨外照射轻度骨髓型急性放射病的临床治疗及远后效应。方法 详细采集患者病史，收集临床资料，从血液系统改变、心理健康等方面进行总结，评价治疗效果，观察远后效应。结果 早期治疗后，患者造血系统改变、心理创伤、无力综合征、神经衰弱综合征均有所改善，受照后第10年患者开始出现粒系、红系、巨核细胞系同时减少，受照后第13年被诊断患有分离转换障碍，病程中还伴有心力衰竭、肝功异常、免疫力低下、神经衰弱等疾病。治疗后可缓解症状，但易反复。结论 本例轻度骨髓型急性放射病在临床表现与远后效应上有其独特的疾病特点，并发症较多，为今后此类疾病的临床救治提供了参考。

Medical follow-up and clinical observation of a case exposed to 192Ir source with mild bone marrow from of ARS

Objective To investigate the clinical treatment and late effects of mild bone marrow form of acute radiation sickness after 12 years of medical follow-up and clinical observation in a case of "7.13" ¹⁹²Ir accident in Harbin in 2005. Methods Collect the patient's history, In detail collect the clinical data, summarize the changes of hematopoietic system and mental health, evaluate the therapeutic effect and observe the late effects. Results After early treatment, the changes of hematopoietic system, psychic trauma, asthenic syndrome and neurasthenia syndrome were all improved. After the first 10 years of exposure, the patient began to experience a decrease in granulocytic system, erythrocyte system, and megakaryocytic system. In the 13th year, the patient was diagnosed with dissociative disorder, heart failure, hepatic Insufficiency, low immunity, neurasthenia and so on. Symptoms can be relieved after treatment, but easy to repeat. Conclusion This case of mild bone marrow form of acute radiation sickness has its unique characteristics and complications in clinical manifestations and late effects, which provides a reference for the clinical treatment of these diseases in the future.